A life course-changing event in real time

This is the most important professional update I have shared until now, and probably the most important that I will ever share. I don’t believe this is an exaggeration.

I was reflecting on this today, and when we think about it, there are in reality very few significantly course-changing events in a lifetime: events that forever change the direction of your life. These are events like leaving home to go to university, doing a long trip to far off places in distant countries, getting married, becoming a parent, moving with your partner and child from your home country to another, completing a PhD, getting a permanent position in yet another country and settling there.

It is also interesting that most of the time it is only in retrospect that it becomes clear that a particular event was, for us, course-changing. We always know that they are important events as they are happening, but usually lack the perspective to appreciate how important or impactful they will grow to become in the overall course of our life. It is therefore rare to have this perspective when one of these life course-changing event happens. This is such a moment.

For me, Kalibra is the seamless merging together of 30 years of study and research in the realm of the quantitative—maths and physics, statistics and probability, modelling and inference, data analysis and interpretation—with 15 years of exploration into the intricacies of the underlying processes that govern the needs and functions of the whole human being—to nourish, move, and rest; to interact, reflect, and grow—bringing to life an entirely personalised guided health journey that feels like a one-on-one conversation and can be scaled to millions of people.

20 years ago, in the fall of 2002, we left our home country of Canada, my wife and our 4-year old son, to move to France where, having completed a BSc in physics at McGill, and then an MSc in particle physics at Carleton, I was going to do a PhD in high energy astrophysics in Paris at the CEA. And 20 years ago, I started to work with the data from the mission INTEGRAL, the International Gamma-Ray Astrophysics Laboratory, that had just been launched on 17 October 2002.

I had absolutely no idea that I would be, 20 years later, celebrating two decades of high energy astronomy with INTEGRAL at a conference I would have organised with a handful of colleagues. A conference which took place in Germany two weeks ago. I had absolutely no idea that after my PhD, I would get a position working at the European Space Agency where I would work for the following 16 years to this day, and would therefore end up devoting 20 whole years of my professional life to this mission as a member of the INTEGRAL Science Operations Centre.

15 years ago I was doing an internet search for information on cholesterol and stumbled upon two articles that completely changed my life: Insulin and Its Metabolic Effects by Ron Rosedale, MD (you can get the pdf here), and The Skinny on Fats by Mary Enig, PhD (get pdf here). This set me on a course of research and discovery in matters of health that proved to be one of my greatest passions. And 11 years ago, at the end of 2011, I started writing on healthfully.net through which I learned so much, and was immensely fortunate to meet, get to know, and gain the trust of many people whom I was able to guide, sometimes very closely, on their health journeys, first of recovery, and then of optimisation, often over periods of several years.

How incredibly rewarding this has been. But how in the world could this sort of caring and personalised guidance be offered and provided to more people? Not dozens, not even hundreds, but thousands and tens of thousands of people, with the personalisation that each one would need?

3 years ago, my cousin Boyana, (the daughter of my mother’s brother), reached out to tell me that her cousin (the son of my aunt’s sister) was retiring from the world of Finance and wanted to do something health tech related. You guys should talk! she said. Ivan called, we talked for a long time, and in that conversation the idea of what would one day be called Kalibra was born.

The first year was mostly just him and I. Two years ago the company was created and began a frantic pace of development that has never relented to this day, with lots of ups and downs, people coming and going, and thousands of hours of intense work, at first by a few, and eventually by a dozen people spread across the globe from Australia to Seattle, through Malaysia and Singapore, to England, Switzerland, Poland and Spain. Today, we are inches away from our first public release.

I am incredibly proud of what we have managed to achieve. And I know it sounds funny because we are in many way just about to start the journey! But you have to think of it as analogous to building a ship before being able to set sail. We are about to finish building the ship, and are getting ready to put it on the water.

I will take great pleasure in writing a series of posts to share the details of this journey that has been these last 3 years between the initial inception and the first release. But for the moment, you can get a good idea about Kalibra by visiting our web page kalibra.ai

One week ago, I turned 50. And it is the first time in my life that I can say with assurance of an event—the event we are about create with the first public release of Kalibra—that it is without a doubt going to be a life course-changing event that will be experienced and witness as such in real time.

Why is it so hard?

Why is it so hard for us to go against the grain? Because we are programmed as social beings who rely on feeling accepted by our peers to feel at ease with ourselves and others.

Why are most accepted opinions and views usually wrong? Because we tend to look at things superficially for the simplest explanations in order to avoid having to acknowledge and work with a wider context that takes into consideration the complexity that stems from the interdependent nature of phenomena.

Why does it still today take so incredibly long—typically many decades—for faulty accepted views to be updated? Because the moment we believe something, no matter how little evidence there is or how tenuous the explanation, that belief becomes a piece of ourselves that helps define our view of the world and of everything in it. That belief becomes an unquestionable part of both our worldview and of ourselves.

Why are we willing and actually prone to fighting, often viciously, to defend our beliefs? Because it is through the collection of our beliefs that we define ourselves, and therefore immediately feel personally attacked when any one of our beliefs is put into question, especially by someone else.

Why do we avoid asking ourselves questions about the world around us, about the statements we hear, about the explanations we are given? Because any kind of process of questioning is bound to bring into question some of our beliefs, and this is a painful process we do not want to engage in.

We humans—we homo sapiens—have been human for about 200 000 years. The fact that we have built the astonishing corpus of knowledge and the breathtaking technologies that we possess today is testament to the incredible power of enquiry of the human mind. But this should not be for one second taken to mean that we are, as a species, different in our most basic tendencies and needs than we were 200 000 years ago.

Fundamentally, our behaviour and thought processes are driven by the overarching need to feel accepted by our peers, independently of how clever we may become at justifying our positions and beliefs to ourselves and others. This is indeed very insidious, because the more clever and educated we become, the more convincing we can be, no matter how wrong we are.

The only remedy is to train ourselves—to force ourselves—to question into our own beliefs. Instead of finding ways to justify them to ourselves and others, to look for ways and reasons to put them into question, and through this process clarify them further.

When we hear a statement, to question into it. When we read an explanation, to question into it. To never settle for what seems to be obvious, but to always question into things.

We need to make this approach—this continuous questioning—our basic mindset. Questioning our own beliefs in exactly the same manner as we question any other belief, statement, explanation.

Questioning, questioning, questioning, and never settling down.

Refocusing on hydration and fasting

I’m not sure about you, but for me, there are two times of the year when it feels natural to take a step back and give ourselves a little more perspective on what we are doing and where we’re going. One is around our birthday, and the other is at the turn of the new year. And out of this process of reflection, it is normally the case that the topic of health is, at one point, highlighted as fundamental.

I’ve been thinking about health for a long time, and because of my training in physics, I regularly come back to first principles, which in this case means the basics: what are the basics, the most impactful aspects, those things that we should keep in mind above all others?

The reason it’s important to come back to the basics is that as our knowledge and understanding deepen, our perspective on how the various elements fit together grows more complete and also more subtle. In my current thinking, I believe the two most important things for health are optimal hydration and fasting.

Fasting

It is odd, in many ways, that what most of us tend to be obsessed about, from the moment we get up to the time we go to bed, is eating. But that eating itself is in fact so secondary compared to not eating.

When we eat, we can nourish. But when we fast, what we do is repair, cleanse, and rebuild the bodymind from the inside out. But what’s critical is that the majority of these repair processes cannot take place unless we are fasting. Isn’t this enough to show us that fasting is on the whole much more important than eating for preservation of health? I certainly think so.

Now, when we do eat, what do we eat? For most of our evolutionary history, this was not a question we had the luxury to ask. Today, however, most things we eat are devoid of nutrition. And not only devoid of nutrition, but filled with anti-nutrients, like phytates and lectins, that prevent absorption of micronutrients and damage the lining of the digestive apparatus. So, what happens when this is repeated every day, month after month, year after year, decade after decade?

What happens is that we see the world in which we live. A world of sickness and disease, of damaged metabolic and digestive systems, weakened and compromised immune systems, premature ageing and death from chronic conditions that arise from overeating and malnutrition, and all of it normal, customary, expected. How stunning it is.

Hydration

Optimal hydration is without any doubt critical to health for two very simple reasons: the first is that the function of every cell in the body depends on the continuous filtration of the blood by the kidneys that rely on optimal hydration to work well. The second is that macroscopically the body is like a bag of salty water: cremating our body leaves behind ashes that amount to 3.5% of the starting mass. That’s really not very much: for a 60 kg person, we’re talking 2 kg; and for an 85 kg person, it’s 3 kg of ash that remain. While optimal hydration is simple, it does require some effort.

We can’t drink too much too quickly. We can’t drink a lot of water without eating enough salt. And we can’t hydrate when the stomach is not empty. We can’t drink too much too quickly because the kidneys filter the blood at a particular pace which is equivalent to approximately 400 ml/hour. Drinking faster than this will dilute the blood (mostly the sodium) and force the kidneys to push water out of the system (through urine). We can’t drink lots without eating enough salt for exactly the same reason. And we can’t hydrate properly unless the stomach is empty because otherwise the water is stuck in there until the breakdown of the protein content is complete.

In conclusion

You can read a lot more about this in our articles that discuss fasting, digestion, and kidney function. The purpose of this post was to give a very short back-to-basics, and with it, an inspiration to refocus on these essential elements of health which are optimal hydration and fasting, and that are, in the end, very simple:

  • Drink approximately 400 ml of clean, filtered water per hour for a total of about 3.5 liters per day (before 20:30 to not get up at night);
  • Have approximately 1 to 2 teaspoons of unrefined salt per day with your one or two meals;
  • Eat a lot less frequently and in smaller quantities;
  • Avoid metabolically and digestively damaging food, and focus on nutrient dense animal foods and green vegetables.

That’s it.

Mindfulness of speech

Have you ever noticed how people most often tend to start their sentences? Have you ever paid attention to how you yourself tend to start your own sentences?

Before acquiring some measure of mindfulness about ourselves—how we are when we are alone, how we hold the body when we are standing, walking, speaking to someone, how the posture is when we sit down, how it feels to wash the hands before eating, how it feels to rinse the shampoo out of our hair in the shower; how we are with others, how we interact, how we speak, how we engage, how we listen—before we gain some mindfulness of these basic aspects of our life, we are not aware of the context in which these details arise. We therefore behave, act and react, in an automatic unconscious manner.

As a result, we, ourselves and most people we know, generally have this in common: practically everything we think and say starts with the word, the article, “I”: “I think that”, “I believe that”, “I feel that”, “I want to”, “I don’t want to”, “I like this”, “I don’t like that”, “I love this”, “I hate that”, and on and on.

This is true whether we are talking to friends, people we just met, family members we’ve known our whole life, or talking to ourselves: “I need to pee”, “I’m hungry”, “I’m thirsty”, “I’m tired”, “I’m sick of this”, and on and on endlessly.

How can we ever actually listen to someone, actually hear what they are saying, take interest in them, understand them, feel their joy or their sadness when they are talking to us, if the only thing we have unconsciously trained ourselves to do is to think and talk about ourselves?

Self-concerned, self-centred, self-absorbed.

But we don’t want to be like that. Do we? So, the first step to take in outgrowing this childish tendency perfected over our lifetime is to become mindful of it. We need to become able to see ourselves doing it. Once we have, more space will immediately become available to us.

This space will allow us to see ourselves more clearly and provide a measure of freedom by which we can begin to exercise a choice in how we speak and how we listen. Through this, we will naturally begin to think differently, see differently, listen differently, and hear differently, more openly, more consciously, more mindfully, and less selfishly.

Try it. When someone tells you something, don’t reply by telling them something about you to shift the focus of the conversation to yourself. Instead, ask them another question. Get them to speak so you can practice listening. Shift your self-centred tendency to taking an interest in them. Shift self-interest to interest towards others: other people, other subjects, other ideas.

Practicing mindfulness of speech is simple: speak less, listen more, and most importantly, listen to yourself speak.

This Blog’s Essential Reading List

Hi there!

If I were to stumble upon this blog today, I would probably feel a little overwhelmed with the volume of stuff, and would wonder where to start.

I’m working with an intern this summer whose job is to extract as many pieces of information we can present and standalone insights from the collection of articles I’ve written. For this reason, I wanted to give her a clear list of what I thought she should read.

So, I spent about an hour going through all the articles that have been published on this blog, and compiled the list of those I consider most important.

Here it is. Hope you find it useful.

Fasting for renewal and rejuvenation

Fasting stimulates autophagy, mitophagy, stem cell production, detoxification, mitochondrial biogenesis, neurogenesis, and neuroplasticity. Fasting also down-regulates muscle catabolism and up-regulates growth hormones to preserve muscle tissue. Because all of these are crucial for health and youthfulness, but tend to decrease rapidly with age, regular fasting is by far the most effective way to naturally slow down ageing and prolong health.

Autophagy means self-eating but refers to the breaking down and removal of damaged tissues, cells, and cellular component to reuse the molecules of which they are made to build new, healthy cells and tissues.

Mitophagy is the same but for mitochondria. Those damaged and dysfunctional are broken down into their constituents to be made available for rebuilding new ones, which is called mitochondrial biogenesis. Fasting is the most effective way to stimulate autophagy and mitophagy primarily through activation of a special enzyme, Adenosine Monophosphate-activated Protein Kinase, or AMPK for short. Fasting also increases production of nerve growth factor that stimulates the growth of new brain cells, no matter how old you are.

Stem cells have as their main purpose to repair tissues. Stem cell activity is highest in embryos and babies, and steadily decreases with age. Stem cell regeneration is strongly stimulated by fasting, but it’s uniquely related to the burning of fat for fuel, and not to the fasting itself. We know this because genetically switching off fat-burning in fasting mice stops stem cell production.

Detoxification takes place through the release of toxins from tissues. Biological survival mechanisms have evolved to sequester into fat cells chemicals and heavy metals from the bloodstream, and isolate them from damaging more sensitive and biologically active tissues and organs in the rest of the body. When fat cells split open to release the energy stored in the fatty acids they stockpile, these toxins are released into circulation for elimination.

Neurogenesis refers to the making of new neurons (brain cells), and neuroplasticity refers to the creation of new synaptic connections and nerve flux pathways in the neural network of the brain. This is without a doubt one of the most remarkable benefits of fasting.

brain-bright

(Image credits here)

All of these biological mechanisms have deep evolutionary roots. We know this because they are common to the most complex (and thus most recent), and to much simpler (and thus much older) organisms. It is most likely in these deep evolutionary roots that the remarkable healing power of fasting comes from.

Autophagy, mitophagy, stem cells, and ketones

Fasting stimulates the breakdown of dysfunctional proteins and cellular components, the preservation of active muscle tissue, and the rebuilding of new proteins and cells upon refeeding. (Read here an excellent article by Dr Jason Fung on the up-regulation of muscle preservation during fasting.) The acute stress of vigorous exercise, especially of strenuous resistance training, stimulates autophagy in much the same way as fasting does. Both stimulate mitochondrial biogenesis. Does this sound inconsequential to you? It really isn’t.

First, the accumulation of damaged cells and cellular debris can be equated to senescence. And senescence can be equated to death. Or rather, the accumulation of death in the body. Death, in this sense, is not really binary, it’s not like one moment we are alive, and the next we’re dead. It’s much more like we accumulate, over time, dead and dysfunctional cells, dead and dysfunctional mitochondria, dead and dysfunctional organelles. Little by little they accumulate, but there’s a threshold. There’s a point beyond which no more death can be accumulated inside the body. And when that threshold is reached, life can no longer be sustained. This is when we die. We call this ageing. The slowing down of things, the loss of energy, the loss of vitality, the loss of strength and flexibility, and the loss of mental acuity and intelligence. But it is, in reality, nothing other than the gradual loss of life through the gradual accumulation of death.

Second, mitochondria are the source of all the energy that is produced and made available to the body. The mitochondria in the cells produce ATP (adenosine triphosphate), the energy currency for all cellular operations and transactions. And no matter how you look at it, every last little bit of energy that is needed to do anything at all comes from these mitochondria in the cells throughout the body. A tiny drop or increase in energy production in the mitochondria would result in a massive effect on your strength, speed, endurance, resilience, but also concentration and sharpness of mind. Why?

Because there are around 30 trillion cells, and most have between 1000 and 2500 mitochondria each. That makes tens of thousands of trillions of mitochondria. The average cell uses 10 billion units of ATP per day, which means an average adult needs about 3 x 10^25 units of ATP per day. Now you can imagine what happens if the ATP production per mitochondria drops or increases by a tiny fraction, say of just a thousandth of a percent. Because there are so many mitochondria, the magnitude of the effect would be enormous.

Do you remember the “blues and greens” that Jeremy Renner and the other agents carried in little aluminum cases around their necks in the Hollywood film The Bourne Legacy? Remember how much they enhanced both physical and mental performance? This is what these little pills’ main purpose was: to increase mitochondrial energy production efficiency.

We don’t usually think about it in this way, but we should. Doing so, we would understand how important it is to support the body in cleansing and clearing out damaged tissues and cellular components so that they don’t accumulate. And we would also understand how important it is to support the body in rebuilding new, healthy cells and mitochondria to maintain optimal function for as long as possible.

Stem cells everywhere in the body appear to love fat-burning. Because fasting triggers fat-burning in basically every cell of the body, it also triggers an explosion in stem cells activity. It is this explosion of stem cell activity that powerfully stimulates tissue repair and regeneration throughout the body’s tissues.

Ketones are produced in the liver by transforming free fatty acids into beta hydroxy butyrate and acetoacetate through beta-oxidation. Ketones are the preferred fuel for the brain and heart, because burning ketones to generate energy (ATP) produces much fewer reactive oxygen species (free radicals), and thereby significantly reduces oxidative damage to the muscle cells in the heart and the neurons in the brain. Isn’t that so amazing?

The relationship between nutritional ketosis and fasting is simple: the brain is one of if not the most crucial organ because it regulates and coordinates almost everything that happens in the body; the metabolic activity of the brain can be fuelled by glucose or ketones; as blood glucose concentration drops and thus becomes less abundant, ketone production in the liver increases to ensure an adequate supply of fuel to the brain. Glucose levels naturally drop within a few hours, even after a carbohydrate-rich meal, due to the action of insulin. Fasting lowers and maintains low blood glucose levels over significantly longer periods of time. Therefore, in general, the longer the fast, the more ketones are produced, and the more are in circulation in the bloodstream.

Burning ketones for fuel stimulates the production, within cells, of antioxidants like superoxide dismutase (that transforms the superoxide radical into molecular oxygen and hydrogen peroxide), and catalase (that breaks down peroxide). Both the superoxide radical and the hydrogen peroxide molecule can cause many types of cellular damage if not neutralised or broken down as early as possible. So, the more ketones available, the more cellular superoxide dismutase produced, and the less cellular damage from free radical damage sustained. Isn’t this amazing?

Ketones also stimulate the production of adenine dinucleotide phosphate (NADPH) and NAD coenzyme that recharge antioxidants like glutathione, ubiquinol, and vitamin C to a functional state. Major functions of NADPH include recharging antioxidants; providing electrons for the synthesis of fatty acid steroids, proteins, and DNA; and acting as the substrate for NADPH oxidase (NOX) which plays a key role in immune function. 

MCT oil and caprylic acid, both derived from coconut oil, are directly and easily converted to fuel and ketones by the liver to fuel brain and heart, and that will therefore bring your lucidity and clarity of mind and thinking. For this reason, they are excellent supplements to take in the morning and during the first part of the day, but should be avoided in the evening because they can lead to hyper-alertness and interfere with a restful sleep. MCT oil shouldn’t be used in case of liver disease.

Nutritional ketosis improves insulin sensitivity, stimulates fat loss, improves mental clarity, reduces risk of cancer, and increases longevity. It reduces cellular damage and inflammation through much lower free-radical and inflammatory cytokine production.  And it also increases cellular and tissue repair by stepping up autophagy, mitophagy, and stem cell activation. All of these benefits are consequences, direct and indirect, of sustained low glucose and low insulin levels, and of the derivation of cellular energy from fats and ketones rather than from glucose. In short, nutritional ketosis is amazingly—actually almost supernaturally—good for you.

Toxins and Detoxification

We are all exposed to many toxic chemicals. No matter where we live, and no matter what we do: mold toxins; heavy metals like Hg, As, Pb, Cd from air, water, and food; arsenic (As) from pressure-treated wood, electronics, herbicides; lead (Pb) from gasoline, water pipes, paints; cadmium (Cd) from fertilizers; copper (Cu) as a by-product of many industrial processes that builds up in soil and water; pesticides and herbicides like glyphosate; PAH (polycyclic aromatic hydrocarbons) produced from the combustion of fossil fuels; BPA (bisphenol A) and phtalates used to make plastics; dioxins and dioxin-like (PCBs) from industrial chemical processes; heterocyclic amines from grilling at high heat; hexane, a neurotoxic chemical used to extract more oil from nuts and seeds (including coconut). The list goes on and on.

These are in the soil, in the food, in the water, and in the air. They are also in the soaps, shampoos, creams, makeup, and the countless number of chemical cleaning agents manufactured and sold the world over that we use in our homes. Obviously, the more of them you avoid direct exposure to the better. Consuming toxin-free food as much as possible, and using the simplest and most natural household and personal care products is an essential first step. But if embryos, as protected as one could ever be deep in a mother’s wombs and behind several layers of protective membranes and mechanisms, are known to accumulate toxins, then what about us?

Most of these chemical toxins are fat-soluble. The biochemical processes that have evolved to transport and isolate environmental toxins, whatever they may be, into fat cells is a remarkable survival mechanism that has without a doubt played an important part in allowing living organisms to evolve over the past 3.5 billion years into increasingly more complex plants and animals. However, the Industrial Revolution led to an explosion of human-made chemicals into the environment the pace of which has never ceased to increase.

Did you know that strawberries contain a fibre called fisetin that help remove and eliminate senescent cells from the body, which is essential for prolonging health? But did you know that they are also some of the most chemically contaminated foods together with spinach, nectarines, apples, grapes, peaches, cherries, pears, tomatoes, celery, potatoes, bell peppers? Among the least contaminated are avocados, sweet corn, pineapple, cabbage, onions, sweat peas, papaya, asparagus, mangos, eggplant, honeydew, kiwi, cantaloupe, cauliflower, and broccoli.

In the past four decades only, more than 85 thousand different chemicals have been released into the environment. And the amount has only increased with time. One of, if not the most dangerous is Monsanto’s infamously well-known glyphosate because it is the most heavily used broad-spectrum herbicide of all time: from 1974 to 2016, soils, waters, plants, and animals have absorbed 1.8 million tons in the US alone, and 9.4 million tons worldwide.

Since 1974 in the U.S., over 1.6 billion kilograms of glyphosate active ingredient have been applied, or 19 % of estimated global use of glyphosate (8.6 billion kilograms). Globally, glyphosate use has risen almost 15-fold since so-called “Roundup Ready,” genetically engineered glyphosate-tolerant crops were introduced in 1996. Two-thirds of the total volume of glyphosate applied in the U.S. from 1974 to 2014 has been sprayed in just the last 10 years. The corresponding share globally is 72 %. In 2014, farmers sprayed enough glyphosate to apply ~1.0 kg/ha (0.8 pound/ acre) on every hectare of U.S.-cultivated cropland and nearly 0.53 kg/ha (0.47 pounds/acre) on all cropland worldwide. (Environmental Sciences Europe, 2016, 28:3)

Our fat cells are the body’s chemical storage facility. The more of them there are, the more chemicals can be stored. The less body fat there is, the less chemicals are stored. And if your storage unit is full, then no matter how hard you try, you won’t be able to add another piece of furniture. This is also true for the body’s chemical storage capacity.  This is both good and bad, but for different reasons.

More storage allows the organism to survive and function even in the face of significant chemical contamination. But the more chemicals are stored in the body’s fatty tissues, the more the organism as a whole becomes contaminated, and the less able it becomes to function optimally. A large dose of chemical exposure, say from a chemical leak, would require a large fat storage capacity in order to prevent overwhelming the rest of the body’s organs and systems. In such circumstances, someone with more body fat would be better off than someone with less.

But for most of us, this kind of acute exposure from a chemical accident in our near vicinity is not much of a concern. Moreover, you shouldn’t imagine that because chemical toxins are stockpiled in fat cells to minimise exposure in other tissues that they have no effect. Does burying radioactive waste makes it innocuous? It makes it a lot less dangerous and damaging, that’s for sure. But only in the short term, and to some extent, because the radioactive wastes leak out into the soil and the ground water.

The same is true for the chemicals stored in our fat cells. The storing of them protects us from the major toxic effects of direct and large scale exposures, but there is some leaking of these toxins out into the system, especially over time, and as our storage tanks get full. In general, therefore, this is what we should be concerned about: the low-grade chronic exposure and its long-term effects. And the less fat storage, the less chronic exposure there will be.

Fasting regularly and smartly, is the best way to both clear out the storage tanks, and  shrink the overall storage capacity for chemical toxins, thus minimising the amount of leaking taking place on a day-to-day basis. So, here’s what we need to know about this:

The more access to fat stores for fuel, the more toxins are mobilised and released from the tissues. This is what we stimulate in the most efficient manner when we fast, because the body needs to sustain all of its cellular processes by burning fat for fuel. But fat loss releases toxins in bloodstream. And this is good because toxins are mobilised.  Detoxification, however, must be supported in order for the toxins to be excreted. Otherwise they are released into circulation and can be very damaging. It is for this reason that water fasting is in general not a great idea: it releases too many toxins too quickly, and offers no mechanisms for bindings and eliminating them.

Once toxins are liberated, they must be bound to something in order to be eliminated. To be liberated, toxins are first made water soluble by the addition of a hydroxy (OH) radical. This is essential for elimination, but it makes the toxin more reactive. In a second stage, the now water-soluble but reactive toxin, is conjugated by the addition of a methyl, sulfur, or acetyl group, or else of an amino acid like glycine or glutathionine, in order to be made less reactive. After this, it is transported out of the cell to be eliminated through urine, sweat, or stools.

The detoxification process is supported by facilitating urination (drinking more); facilitating passive sweating (sauna, near-IR is best); eating cruciferous vegetables (broccoli, cauliflower, cabbage, Brussel sprouts, and kale); and supplementing with toxin binders (activated charcoal, chlorella, chitosan, psyllium husks, and citrus pectin). Actually, fat regain following fat loss, something which is very common, is almost certainly a protective mechanism to sequester the toxins that were released but not eliminated. And sweating has to be passive, because exercise suppresses detoxification: the system can be either in fight-or-flight or in rest-and-repair mode; exercise is associated with the former.  

Effective detoxification depends on healthy intestinal function. A compromised gut lining allows toxins from the foods or process of digestion to enter the bloodstream. This leads to chronic inflammation and a chronically triggered immune system that eventually results in autoimmune conditions. Fasting reduces gut permeability by enhancing integrity of gut lining: it induces a metabolic switch to fat-burning in the intestinal stem cells that significantly enhances their function, and promotes the healing of the junction between gut lining cells, as well as gut flora diversity.

Resistant starches are good because they feed the gut bacteria, and do not break down into glucose. They are found in under-ripe bananas, papayas, and mangos. Most notable is that if rice is cooked with coconut oil, allowed to cool for 12 hours, and reheated, it will increase in resistant starch by a factor of 10! This reduces calories that would be absorbed from the starch going to glucose by 60%! This simple preparation of the rice turns it from a damaging high-sugar food to avoid, into a beneficial prebiotic. Quite amazing, isn’t it?

How to fast: first steps

Now, before going any further, you should not fast if you are underweight or malnourished; pregnant or breastfeeding; or if you have excessively high uric acid levels. Fasting while underweight or malnourished will exacerbate the negative consequences of the malnourishment. Fasting while pregnant or breastfeeding will release toxins that could potentially be highly detrimental to the baby. And because fasting naturally increase uric acid levels due to the process of cellular cleaning, it could, if starting from an already excessively high concentration, be damaging to the organism. Otherwise, fasting will in general be very beneficial.

First, because fasting strongly influences the regulation of the circadian rhythm, and because one of the most important functions of sleep is to clean out the brain from the byproducts and wastes of its metabolic activity during the waking hours, we should never eat during the night, and always allow at the very least three but preferably four to five hours from our last bite to the time we go to bed. This is necessary to set the conditions for a deep, restorative sleep that keeps our brain in good shape. This is true independently of everything else. So, you can start doing this right away without even having to do any prolonged fasting.

Second, in order to avoid a negative impact on your mental and physical performance during the fast, the body should be adapted to using fat for fuel before you start fasting. You will feel shitty otherwise. I have written two articles that relate to this: Keto-adaptation for optimal physical performance and The crux of intermittent fasting. You should read both. It’s important to understand the biochemical and physiological foundations of why we do things in a particular way. Otherwise, we will lack the intellectual understanding on which depends our ability to make informed choices, but also the resolve to see them through.

Third, in order to have a smooth transition to longer fasting periods, you need to increase your fasting window gradually: to gradually increase the time between your last bite in the evening, and your first bite the next day. Let’s say your sleeping schedule is near optimal, sleeping from 22:00-23:00 to 7:00-8:00. Let’s also assume that you make sure you leave 4 hours before going to bed so that you have your last bite of food around 18:00. Everyone should fast for at least 12 hours. That’s the minimum to aim for, and it requires very little effort.

It would be much better to fast for at least 14 hours, in which case you would wait until 9:00 before having any food. A 16-hour fast would bring you to 11:00 for a late breakfast or early lunch. An 18-hour fast would have you eating lunch at 13:00. And a 20-hour fast means you would be having your first meal around 15:00. Take as long as you need to gradually go from the minimum of 12 hours to at least 16, 18, or even 20 hours.

When you can do this, you will know for sure that your metabolism is well fat-adapted, that your liver is producing ketones efficiently to nourish your brain during fasting periods, that the coarsest detoxification has to a great extent taken place during those weeks or months you have been adapting to longer fasting periods, and that you are now ready to extend your fasts to 24 or 36 hours once in a while, or as much as a couple of times a week. It is far more beneficial on the long term to fast for shorter periods of time every day, then it is to fast for a longer time less frequently. Because each time we fast and then refeed, we activate and benefit from the health-promoting and youth-enhancing mechanisms of the body.

Eating protein activates the mTOR (mammalian or mechanistic target of rapamycin) pathway, which is a powerful catabolic (tissue breakdown) that raises blood sugar levels. Hence, in general, we should keep protein intake to the optimal minimum for our needs. That’s something like this:

  • Young: 1g/kg of lean body mass per day
  • Older: 1.2g/kg of lean mass per day
  • Athletes: 1.5g/kg of lean mass per day

It’s important to remember that beyond the minimum optimal amount, protein intake should be adapted to level of activity: more activity means more protein, and less activity means less protein. Once you are well fat-adapted—after about 8 weeks on a very low carbohydrate diet—you should make a point of having a high fruit and/or starch day once a week. This will ensure that you maintain metabolic flexibility and a perky insulin response. Long term nutritional ketosis can lead to a sluggish insulin response, higher-than-optimal glucose levels and thus glycation, and otherwise unwanted biochemical and hormonal adaptations, which will prevent fat-loss and promote muscle breakdown. Variety stimulates metabolic flexibility.

But make sure it’s clear to you what this means: it means staying in nutritional ketosis for at least 5 days per week. And having a high-carb day means having between 100 and 150 g of sugar/starch from fruit, sweet potatoes, or rice. You should also make that high-carb day a low-fat day. In addition, digestion quality must remain your top priority. This means having your fruit or starches on their own as much as possible, and avoiding combining them with a lot of protein, which will compromise the digestion of both.

How to fast: specifics of keto-fasting

Very importantly, clearance of damaged cells and cellular debris or damaged organelles takes place during fasting, but rebuilding of organelles, cells, and tissues, most notably liver rejuvenation, occurs during refeeding.

Ketofasting following Dr Joseph Mercola’s method is partial fasting lasting ideally around 24 to 36 hours and up to 48 hours. It starts after the last meal of the day, extending over the course of the day following that, either ending with a meal 24 hours later; extending through a second night and ending at the start of the next day for the 36 hour fast; or extending 48 hours to latter part of the day. We saw why water-fasting is not something most of us should be doing in this day and age, and why it’s important to support the detoxification process while fasting. This requires some inputs: it requires protein (amino acids), mitochondrial support, and toxin binders.

The notion of breaking a fast is often taken as binary: we are either fasting or we are not. To some extent this is true. But in many ways it is not. It depends a lot on what it is that we ingest. The essential point is that the benefits of fasting come from maintaining very low blood sugar levels, remaining in nutritional ketosis, and therefore keeping the body in a cleanse-detoxify-repair mode.

Hence, there is a big difference between ingesting a teaspoon of coconut oil or a teaspoon of honey: both provide some calories, but the former supplies only fatty acids that actually promote nutritional ketosis, while the later supplies only simple carbohydrates that will immediately raise blood sugar levels and suppress ketosis, albeit temporarily, and more or less, depending on several other factors defining the body’s metabolic state and efficiency. So, in this regard, it’s better to think of fasting as grey rather than strictly black and white. Naturally, it’s really not an issue to have cucumber and celery with salt, for example.

Protein intake, needed to support the detoxifications processes, should be about half of your daily requirement, for example, 45 g instead of 90 g for 60 kg of lean body mass exercising 3-4 per week. During fasting, protein should not be branched-chain amino acids (BCAAs) nor animal protein rich in BCAAs, because they activate the mTOR pathway that inhibits autophagy. The rest of the calories should be from fat to reach 300-600 kcal from coconut oil, MCT oil, or caprylic acid. Even small amounts of 85% chocolate for which each 10 g square provides 5.3 g of fat, 0.8 g of protein, and 1.5 g of sugar, amounting to 62 kCal of which 48 are from fat, 3.2 from protein, and 6 kCal are from sugar. These are all considered supplemental levels.

In fact, because the purpose of eating protein is to supply amino acids in support of basic functions and detoxification, it is most effective to replace protein intake by an amino acid supplement. And because converstion of protein to amino acids is at most 1/3 efficient, meaning that the highest quality animal protein (e.g., beef) will yield at most 1/3 of its amino acid contents once digested, we can replace 45 g of protein by 15 g of amino acids. Splitting this intake into 4 doses of 4 g each makes for a good rhythm of taking these every couple of hours over 8 hours or so. And they can be taken together with the chlorella and spirulina supplements as well as the phospholipids.

Even though exercising suppresses hunger due to the increase of stress hormones, unfortunately, it also suppresses detoxification. For this reason, you shouldn’t do strenuous exercise on fasting days. Focus on rest and repair.

Supplements to support autophagy and toxin elimination include:

  • Ubiquinol 100-150 mg twice to support mitochondrial energy production, regulate gene expression of processes related to inflammation, growth, and cellular detoxification.
  • Phosphatidylcholine and broad spectrum phospholipid to support rebuilding and thereby eliminating chemicals from cell membranes, especially in the brain.
  • Probiotics (not dairy-based) to help rebuild/balance gut flora if digestion is suboptimal. Keep in mind that the natural flora of the gut is adapted and adapts according to food and drink intake, as well as to the daily rhythms.
  • Bitters to support the liver in cleansing and elimination (e.g., Dr Shade’s Liver Sauce by Quicksilver Scientific; Swedish Bitters by Flora or by Maria Treben; herbs like Gentian, Dandelion, Goldenrod, Myrrh.)
  • Binders to support elimination of toxins, all to be taken on an empty stomach to not interfere for nutrient absorption in the gut:
    • Psyllium husks (1 tbs 1-2 times/day) stirred into a large glass of water—binds to stuff in gut to eliminate in stools;
    • Charcoal capsules (3 caps 1-2 times/day)—binds and removes pathogenic bacteria, Pb, Hg, and excess Fe;
    • Chitosan (2-3 g)—binds and removes heavy metals and radionucleotides;
    • Modified citrus pectin (5 g 1-3 times/day)—binds and removes dead/weak cells;
    • Chlorella—binds and removes Hg, but also provides a balanced plant protein.

Refeeding is as important as fasting, because this is when the rebuilding takes place. It is very important to remember that. Unless you are overweight and carrying around a lot of energy reserves in the form of extra body fat, intermittent fasting is not a matter of replacing three meals with only one. You need to provide the body with all the energy, macro and micro nutrients it needs to thrive. This remains true under all circumstances. Therefore, you need to make sure to not fall into the trap of eating 1/3 of what you normally would, and grow thinner and  thinner with time. That is not the point, and is obviously not sustainable in the long term. You need to provide the bodymind all the nutrition and calories it needs. The key is that this is true on average: If you don’t eat for extended periods of time, you naturally need to eat more when you do.

Concluding remarks

As time goes on and as our technological means of detailed investigations at the cellular level improve, we discover more and more amazing health-enhancing mechanisms through which fasting acts on the organism to make it stronger, more resilient, more functional, and more youthful.

But beyond all the super cool details about the mechanisms by which fasting works its magic on our body and brain, the essential message here is that fasting is really good for us. It’s in fact so good that it’s amazing. And considering that it can stimulate the growth of new mitochondria and even new brain cells, we could even say that it’s miraculously good for us.

Having understood that it is the combination of the fasting period and the refeeding that follows which makes the magic happen, the natural question is how can we maximise this. And the answer is quite simple: we fast and refeed frequently. We fast long enough to activate the health-enhancing cleansing, detoxification, and preservation mechanisms and pathways, and refeed with the most nutrient dense and nutritious foods to maximise the efficiency and effectiveness of the rebuilding and renewal mechanisms and processes.

Once well keto-adapted, and after a period of gradual adaptation to longer fasts, it becomes very easy, and even natural, to fast daily from 18:00 to 12:00 or even 14:00. It even becomes easy and natural to eat two small meals or a single large meal just once a day. In this way, we can get the benefits of fasting and refeeding every single day. Of course, longer fasts of 2, 3, or 4 days will go deeper in stimulating the cleansing, preservation, and repair potential of the fast. But the longer the fast, the more difficult it grows to maintain, and the less frequently it can be done because the rebuilding in between fasts must also be longer. After all, our daily requirements for calories and nutrients is what it is, and although we can easily postpone providing the organism what it needs to function optimally for some time, everything it needs must eventually nevertheless be provided.

This is therefore what I do. A daily fast of about 16 to 20, and usually 18 hours. Once or twice a week a full day’s fast with a single large meal, but typically one small meal around 14 and one larger one around 17 or 18. A comprehensive daily supplement programme; bitters over extended periods a couple of times a year; binders like psyllium husks semi regularly according to need based on quality of bowel movements, and smell of underarm sweat; maximum hydration and alkalisation of body fluids during the fast; and most fundamentally, maximum nutrition at refeeding. Maximum nutrition and nutrient density from plant foods, and maximum nutrition and nutrient density from animal foods. And the final note I’d like to leave you with is this:

The process of ageing is the process of dying. And this process of ageing and dying is a very slow and gradual process of accumulating dead and dysfunctional cells, mitochondria, organelles, and tissues. As these accumulate, we age and die. The faster they accumulate, the faster we age and die. The more we have accumulated, the closer we are to the end, to the threshold beyond which the organism cannot sustain its activity. Fasting—and this is the single most essential benefit of fasting—is by far the most effective way to slow down, minimise, prevent this continuous accumulation of death, and instead promote and stimulate cleansing, renewal, and rejuvenation within this organism that we call our bodymind.

I hope all of what we saw here together will help you enhance your health, and improve the quality of your life.

This article is inspired by and primarily based on KetoFast by Dr. Joseph Mercola.

Thank you to all our patrons, and in particular to Eric Peters, Sappho Griffin, Toni Bates, and Bostjan Erzen, for their support. Become a proud sponsor of healthfully.net and join our patrons

Is it possible to make universal recommendations about health?

Focus these days tends to be on individuality. Especially in this age of genetic testing. The fact is, however, that ahead of individual differences, we are all human. Not only that, but as far as we know today, with the latest studies of mitochondrial gene evolution and transmission, we are all descendants of the same group of homo sapiens from the south western coast of Africa. Hence the question: can we make universal recommendations?

Imagine we could examine every human being on the planet, and assess organ function. For example, examine function of the kidneys, liver, pancreas, gall bladder, stomach, small intestine, and large intestine. Would we find differences in how these are working from one person to another? Of course we would! That’s obvious. But does that have to do with inherent individual differences, or does it have to do with acquired differences that have developed over time for a range of different reasons? What if we were to ask this question instead: is there a difference, from one person to another, in how these organs are meant to work, a difference in how these organs should be working?

If that were the question, we would most certainly agree, together with probably all anatomists and physiologists, that all of these organs, and the rest of the internal organs of our organism, are meant to work in the same way. That all these organs, no matter in which person they happen to be, and no matter how they are currently working, are nevertheless meant to work in precisely the same way to perform precisely the same functions. And this not only in humans, but also in most animals with whom we share these fundamental anatomical and physiological characteristics. This naturally points not to individual differences but to inherent similarities as the fundamentally essential.

It is however quite easy to understand why there is so much emphasis on individuality. Aren’t we all unique and different? Aren’t we all so special in this uniqueness? Don’t we all have to learn to listen to our inner voice and pursue what we need to feel fulfilled in our own unique way? And how cool it is to be able to know our genetic profile, our own, completely unique, personal, and individual genetic profile? How special does it make us feel to know that there isn’t a single other person that has the same genetic profile as us?

What if everyone was brought to believe that each type of cancer is different, not superficially but fundamentally, and that in addition, each type is expressed differently in each individual because of the different interactions with their unique genetic makeup? That it is necessary to treat each individual cancer and each individual person with a drug that is genetically tailored just for them in their particular situation? What if we were brought to believe that this was the case for most illnesses and chronic diseases: that what is needed are specific drugs for specific conditions that are genetically tailored to each person? What endless possibilities! What awesome growth potential! What amazing investment opportunities! And what astronomical potential for returns on investments!

Contrast this with a position holding that cancer is a metabolic disease, and that no matter what kind it is, fundamentally cancer is always caused by a mitochondrial dysfunction that leads to excessive fermentation of glucose for fueling accelerated reproduction and a cellular activity that has become undifferentiated, and that therefore, all cancers can be prevented and even reversed by effectively starving the cancer cells of fuel by maintaining very low glucose and very low insulin levels in the bloodstream to ensure that healthy cells derive their energy from fatty acids and ketones, while the weakened and dysfunctional cancer cells starve and die. What growth potential? What investment opportunities? What returns on investments?

Contrast this with a position holding that all chronic diseases are also rooted in metabolic dysfunctions, and arise, simply and naturally, in a rather predictable manner, from things like chronic dehydration, chronic dysfunctions in digestion, absorption, and elimination, chronic nutritional deficiencies, biochemical imbalances, accumulation of metabolic acids and wastes, and result from all the consequences brought on by these dysfunctions and imbalances over years and decades that grow in severity in time until we are really quite sick, but all of them very simply prevented and treated with proper self care, hydration, and nutrition. Again we can ask, what growth potential, what investment opportunities, what returns on investments?

Whatever your personal inclination about any of this, it’s definitely something to keep in mind when evaluating statements concerning the general applicability versus the individual tailoring of treatments for ailments and approaches to health.

My position is simple:

  • as living organisms and complex animals, all humans are basically the same in anatomy and physiology;
  • there are obvious differences from one person to another that must be taken into account when considering each person individually; but
  • on the whole similarities are many and fundamental, while differences are fewer and generally superficial.

This is not to say that differences can be dismissed or even overlooked. Of course not. There are important differences in the expression of fundamental genes like the MTHRF gene that regulates methylation in the body, and which hence directly affects the body’s biochemistry and state of health. Similarly, there are important differences in response to sunlight and vitamin D metabolism from one person to another, even people from the same general gene pool. But these are nevertheless superficial compared to the totally fundamental considerations of how cells, organs, systems, and hormones work.

With all of this in mind, let’s come to the main point: what recommendations I would make with confidence to any adult not suffering from a major disorder, younger or older, weaker or stronger, more fragile or more robust, knowing that these recommendations would in no way be harmful, and would instead be helpful to improve health. They are presented in order of importance.

  1. Drink plenty of water and eat plenty of unrefined salt with meals. This is essential for proper hydration on which every cell relies, and proper kidney function on which the organism as a whole relies.
  2. Get at least 8 hours of quality sleep per night, on a regular schedule, somewhere between 21:00 and 8:00 the next day. Nothing is more important for health than sleep, and there is no way in which we can make up for a lack of it.
  3. Practice intermittent fasting. Nothing offers a more effective way to cleanse, repair, heal, and optimise cells, tissues, organs and metabolic function than fasting.
  4. Eat only nutrient dense whole foods. Ideally organic and pasture raised, focusing on high quality animal protein and fats, and micronutrient dense plant foods, avoiding all processed carbohydrates, lectins from grains and nightshades, and any foods to which you may be intolerant (e.g., dairy, eggs, nuts, etc).
  5. Take vitamins A, D3, and K2. These are fundamentally important fat-soluble vitamins, essential for healthy gene expression, calcium metabolism, healthy bones and teeth, and healthy arteries and soft tissues throughout the body.
  6. Take baking soda. Start the day with half to three quarters of a teaspoon of baking soda dissolved in a large glass of water on a completely empty stomach. This is the easiest way to supply the most important alkaline compound used by the body, and offset the acid load and potential accumulation in tissues of metabolic acids.
  7. Take iodine. This is essential for healthy thyroid, mammary, and glandular function in general. But iodine is needed in every cell, and basically everyone is iodine deficient. Unless you live by the sea and eat fish and seafood regularly, you need extra iodine (either in pills or by eating sea vegetables).
  8. Take magnesium. This mineral is also needed by all cells, but especially muscle cells that need and use up magnesium in order to relax, and our soils are globally deficient in it. Thus, naturally, so are we. Contraction of muscle requires calcium, which is quite abundant in our diet; relaxation requires magnesium, which is, on the contrary, rather scare in our food supply.
  9. Practice resistance training. Focus on large compound exercises like the deadlift, squat, benchpress, and standing overhead press. There is no way more effective to maintain a strong and healthy balanced musculature, nervous system, skeletal structure, and hormonal system than whole body exertion through complex lifts with sufficient resistance.
  10. Find purpose and fulfillment in your life. This is fundamental. Without a sense of purpose we feel useless, unneeded, unwanted. Without a sense of fulfillment from what we do, we feel hollow, empty, worthless. It is therefore essential to find and to actively seek to maintain a strong sense of purpose, and a feeling of fulfillment in life. Do not take this lightly. Look into it and find it.

Here you have it: ten simple recommendations for a healthy life. And, from the perspective presented here, ten universal recommendations for any adult without a major disorder requiring specific considerations, which are sure to not cause harm, and instead sure to bring about improvements and benefits to metabolic, hormonal, muscular, skeletal, and physiological functions of the organism as a whole. Therefore, in conclusion, I would say that yes, it is possible to make universal recommendations about health.

 

Thank you to all our patrons, and in particular to Eric Peters, Sappho Griffin, Toni Bates, and Bostjan Erzen, for their support. Become a proud sponsor of healthfully.net and join our patrons today!

Stop the bleeding and heal the tissues

This is a healing programme for someone who has had chronic haemorrhoids and bleeding for a long time. Following an operation that was supposed to resolve the problem, the situation worsened, the bleeding increased, and consequently, they now have haematologic issues. The situation could quickly become critical.

Good morning,

In all likelihood, the cause of all the blood-related problems is the colon dysfunction, hemorrhoids, and most importantly the bleeding from the anus. This needs to be corrected before things get much worse. The basic strategy is to minimise bowel movements until the colon and anus have healed, and maximise the speed of healing and nutrient density specific to blood building. 

Eat no fibres

To allow the colon and anus to heal, we need to stop stressing their tissues, which means less bowel movements. This will be done by eating only animal foods and zero plant fibres. In your case, this means animal flesh, fat, and organ meat only (no eggs or dairy products). No matter what anybody you may talk to thinks about it, this is a perfectly healthy way to eat that eliminates all low density nutrient food sources, and is in fact used very successfully to treat and heal serious autoimmune conditions that do not respond to other kinds of treatments. It provides an extremely nutritious diet because all animal foods are concentrated sources of proteins and protein-bound nutrients, fats and fat-soluble nutrients, that are all easy to absorb and digest because the gut is free of intervening fibres that slow down or prevent absorption, and contain none of the natural toxins found in all plants to a greater or lesser extent. You can read many testimonials, some truly amazing, on Zero Carb Zen.

It is important to keep in mind that while protein is used for tissue building and repair, it is fat that is used for cellular energy production. Hence, you need to have plenty of fat and salt with your meals. You should have always have liberal amounts of the highest quality grass fed butter, extra virgin organic coconut oil, extra virgin olive oil, and unrefined sea salt.

Build blood with liver and chlorophyll

There is nothing more effective at building blood than liver from the animal food world and chlorophyll from the plant food world. So, you will have both. Liver should be grass fed veal liver, as it is one of the most nutritious. But other animal livers including chicken are also good. It is very interesting to note that chlorophyll is really like plant blood because it has the same structure as haemoglobin with the only difference being that its central component is Mg instead of Fe for haemoglobin.

I think that in order to accelerate healing, you should have liver every day, but in small amounts, like 50 g. The chlorophyll you will have with water. You can either have it more concentrated (in a single glass of water) and have it 2-3 times per day, or you can have it more diluted and have it over longer periods. The taste might be any issue, so you can see what works best for you. Also, you need to be cautious to not take too much as this will cause loose stools. You need to increase your intake gradually. Naturally, all zero-to-very-low sugar green juices are also excellent to have as much as you want. You should always add a little olive oil to your green juices to increase absorption of nutrients.

Supplements: Chlorophyll

Accelerate healing with amino acids and proteolytic enzymes

To maximize the speed of healing you will take amino acids that, as a supplement, are almost 100% absorbed without any inefficiencies related to compromised digestion. The first place they will be used it for tissue repair. Proteolytic enzyme are the specialised proteins that actually perform the breakdown of damaged tissue, as well as the repair and rebuilding of tissues throughout the body.

They should both always be taken on an empty stomach and at least one hour before eating anything. They can be taken several times a day, so I suggest 3-4 times, taking 3-5 amino acid tablets and 3 proteolytic enzyme capsules each time, first thing in the morning, one hour before the midday meal, one hour before the evening meal, and before bed. Vitamin A is also essential for tissue repair, but liver is one of the richest sources of it, so you don’t need to take extra.

Supplements: Amino acids and proteolytic enzymes

Moisturise skin with oil

The last thing is to help the tissue of the anus from the outside by putting some olive oil with a small amount of essential oils of lavender and geranium. The proportion is 3 drops of each essential oil for 30 ml of oil. Dip your finger only once in the small oil container, and moisturise the skin around the anus. Do this a few times per day, and always before and after a bowel movement.

Following these recommendations, you should see improvements very soon, but as is always the case, healing time is proportional to the time over which disease and damage has persisted. So, be consistent and patient.

 

Thank you to all our patrons, and in particular to Eric Peters, Toni, and Bostjan Erzen, for their continued support. Become a proud sponsor of healthfully.net and join our patrons today!

Your gallbladder and why it’s important

Yesterday I had a video coaching session with one of my patrons, and the last thing we talked about was the gall bladder. They recently had an ultrasound done to check out the insides of the abdomen—obviously to make sure everything looks good. The kidneys looked good, the liver had a small benign lump of 1–2 mm  in size (angioma sounds so much more serious), and the gall bladder had a bunch of little stones. I asked what the doctor recommended.

“There’s nothing to worry about. Let’s check again in half a year.” That was it. Nothing more. So, they asked me if there was anything that could be done to help in some way.

What do you think? Is there not always something that can be done to help—to help the body cleanse itself, repair itself, heal itself, improve its physiological and metabolic functions?

We’ll take the time to study and explore the liver and its functions in greater detail later—the liver is a lot more complex. The gall bladder is quite simple, and so, I just wanted to share with you what I explained yesterday, and at the same time, take the opportunity to expand a little on that.

First the Anatomy

Looking at the abdomen from the bottom of the sternum (the bone between the pectorals) to below the hips, after having removed the skin and layers of muscle, cut out the front part of the ribs, and changed the appearance to make it cartoon-like, without any blood, veins, arteries, or nerves, and thus not so shocking to look at, we would see something like this:

abdomen-front-labels

Digestive system: front view with labels

The large, dark red organ that is the liver sits at the very top of the abdomen with its largest lobe located on the right side of the body. On the left, below the liver’s smaller left lobe, is the stomach that curves back towards the middle where it connects to the small intestine (duodenum). The gallbladder—the small dark green pouch—is nestled between the bottom of the liver’s right lobe and the first part of the duodenum. Below the stomach, sweeping across the abdomen from one side of the body to the other is the transverse part of the large intestine (colon). The entire lower portion of the abdomen is filled with the longest segment of the intestines.

If we zoom in on the upper abdomen,

upper-abdomen-front-nolabels

Upper digestive system: close up front view

and then hide the liver,

upper-abdomen-front-noLiver-nolabels

Upper digestive system: close up front view without liver to show bile ducts

we see all of the little green ducts embedded into the liver whose function it is carry the bile from the different parts of the organ to the main bile duct and gallbladder.

Taking a look at the same part of the abdomen from the back,

upper-abdomen-back-top-labels

Upper digestive system: close up back view with labels

we see how the gallbladder sits between the liver and duodenum, and how the main bile duct sweeps down behind the pancreas to connect to the main pancreatic duct such that the bile from the liver and gallbladder can be injected into the small intestine together with the enzymes, insulin, glucagon, and bicarbonate from the pancreas. We also see from this side the dark red, bean shaped, right and left kidneys, and the yellow adrenal glands sitting on top of them.

And then the physiology

Why do we need bile and what does it do? Why is there a gallbladder? And what is bile anyway?

Bile is 97% water, 0.7% bile salts (sodium and potassium), 0.5% cholesterol, fatty acids, and lecithin, 0.2% bilirubin, and a tiny bit of inorganic salts. In human adults the liver produces 400–800 ml of bile per day (Wikipedia).

The liver produces bile continuously but slowly. When we eat, depending on how much fat there is in the meal, the digestive system may need quite a bit of bile to handle the fat that was just ingested. Hence the need for storage and thus the function of the gallbladder.

The purpose of bile is to emulsify fat. Emulsifying means making into tiny droplets that can mix into another liquid to form a smooth homogeneous solution. For example, a bit of mustard works very well to emulsify the oil and vinegar that would otherwise not mix into a smooth creamy vinaigrette. After emulsification, fat droplets are typically 15–30 microns in size.

We need bile to emulsify the fats that we eat so that the pancreatic enzyme lipase can then break these triglycerides down into monoglycerides and free fatty acids. This is done in the small intestine where the bile and enzymes are secreted from the pancreas with the bicarbonate solution. This in turn allows the fat to be transported through the intestinal wall before being reassembled into triglycerides and absorbed into the lymphatic system. Without bile, fat could not be absorbed. It would go straight through the gut and be excreted undigested.

Why would stones form in the gallbladder? Is there a way to prevent the formation of gallstones? And what actually are these gallstones?

Gallstones are basically little hard lumps of cholesterol. One of the functions of the gallbladder is to concentrate the bile which comes in quite diluted, as we saw earlier, being 97% water. But when the concentration grows too high, then cholesterol precipitates out and forms little lumps. These are what we call gallstones.

Given that we know that stones form out of precipitated cholesterol when the concentration of the bile is too high in the gallbladder, it is simply logical that if the concentration can be kept low enough, below the threshold at which cholesterol will precipitate, then no stones would form. But why does the concentration of bile grow to the point of precipitation?

Let’s ask another question: what happens if we don’t eat much fat? The liver produces bile continuously, between 400 and 800 ml per day. This bile is stored into the gallbladder until it is needed after a meal in which fat was ingested. If we don’t eat much fat in a meal, then, naturally, not much bile will be needed, and most of the available bile will therefore remain in the gallbladder. Because the liver continues to produce it, the gallbladder needs to make room for it, and thus concentrate its contents further.

So, what happens if we never eat very much fat, and if actually, every meal is a relatively low fat meal? Well, what happens in a pool of water if the water does not flow out, and is by this not renewed by fresh water? Stagnation. In the case of the pool of water, we all know what happens: it grows dirty, then thick, then greenish, then totally filled with lumpy green gelatinous stuff. In the case of the gallbladder, we can imagine that something analogous takes place, and that the lumps of cholesterol are like the lumps of green gelatinous stuff in the water.

The solution is simple: eat plenty of fat on a regular basis. This way, the gallbladder can empty itself out regularly, and the bile does not stagnate, grow more concentrated, and eventually lumpy with gallstones.

Your gallbladder and why it’s important

Here’s what we learned:

The gallbladder sits between the right lobe of the liver and the first part of the small intestine. It stores and concentrates bile which is mostly water with small amounts of salts, bilirubin, lecithin, and cholesterol. The liver produces bile continuously in the amount of 400 to 800 ml per day.

The function of bile is to emulsify the fat we eat to make it absorbable. Without bile, fat just go through and gets excreted undigested. The same is therefore true for all fat-soluble minerals and vitamins, including some of the most important of them all, the crucial vitamins A, D, E, and K2.

If we don’t eat fat, there’s no need for bile. If we don’t eat much fat for a long time, the bile will get more and more concentrated. Eventually, the concentration will be high enough for cholesterol to precipitate out of the bile and form little lumps. These lumps of cholesterol are called gallstones.

Imagine that this continues for years and even decades, following a good “heart-healthy” low-fat diet. What do you think will eventually happen based on what we’ve just discussed? More stagnation, more highly concentrated bile, more gallstones, and then at one point, this whole thing explodes into acute infection, acute inflammation, excruciating pain, and emergency surgery to remove the infected gallbladder.

And then what? I’ll you finish this exercise in deductive reasoning which you now have all the necessary background to complete.

 

Thank you to all our patrons, and in particular Eric Peters and Toni, for their continued support. Become a proud sponsor of healthfully and join our patrons today!

Why every undigested protein is an allergen

We come out of our mother’s womb, and we are very soon thereafter given a bottle to suckle on. In the bottle there’s a powdered ‘infant formula’ mixed with water, or milk, or both. “The most commonly used infant formulas contain purified cow’s milk whey and casein as a protein source, a blend of vegetable oils as a fat source, lactose as a carbohydrate source, a vitamin-mineral mix, and other ingredients depending on the manufacturer” (source: Wikipedia). The water is municipal tap water with residues of agricultural and industrial chemicals, of prescription drugs of various kinds, fluoride that suppresses the immune system and makes the bones and teeth brittle, and chlorine that kills the bacteria and destroys the flora of the gut. The milk is most likely UHT, which stands for ultra high temperature pasteurised, cow’s milk from cows that have never set food outside, have never eaten a blade of grass, have only ever eaten soy, oats, and corn, and have their whole lives received antibiotics preventatively to lower the probability infection due to the fact that they are sick and immunosuppressed from the living conditions they are subjected to. How’s that for a start?

We start teething and we are given ‘teething cookies’ to nibble on. Cookies, like Gerber’s classic arrowroot cookie, made wheat and arrowroot flours, dairy proteins and solids, vegetable oils, sugars, and other stuff like stabilisers, preservatives, texture and flavour enhancers, and some added vitamins and minerals, of course.

We don’t need to have teeth to have ice cream. In fact, parents are encouraged to give cold things like ice cream teething infants to soothe their gums aching from the teeth pushing through them. And we love it, of course! We’re still far from being able to speak, but we eagerly await the next spoonful, which, if delayed too long, makes us impatient, and soon angry enough to cry out and let our parents know we want more.

Naturally, we never make a fuss when we are fed apple sauce, or pear sauce, or pureed bananas, peaches, or apricots, nor when we are are given mixes like banana-strawberry, or strawberry-kiwi, or even apple-carrot-parsnips. We also like sweet potatoes, squash, and even regular mashed potatoes with our pureed meals. But the green things like mashed pees or broccoli, that we like less—quite a lot less.

We always start the day with orange juice. In fact, this is so much a part of our upbringing that we can’t even imagine a morning with having orange juice. And as soon as we can chew, our breakfast is made of those delicious, sweet and crunchy cereals served in a big bowl of milk. This is another part of our upbringing that is so much a part of us that we  often consider it a normal part of life, and can’t imagine a life with it.

We snack on cookies, on muffins, on granola bars, and particularly like the chocolate covered ones. We snack on chips, crunchy and salty—on Doritos, Pringles, and all sorts of different kinds of chips—and we love them too. We love our regular home pasta dinners, our pizza dinners, our hot dogs, our burgers, our fries. When we’re hungry in the afternoon, we make ourselves those delicious peanut butter and raspberry jam sandwiches on ultra moist slices of white bread, and they’re so good we have a hard time to stop eating them one after another. And what about our Nutella, that amazing chocolate spread we can never have enough of? We really could eat the whole jar if we didn’t force ourselves to stop. It’s so delicious we even eat it by the spoonful when we don’t feel like having bread with it. And they tell us it’s good for us, that’s a good source of nutritious milk and hazelnuts. Wow! How great!

We get sick pretty often as school children, but not more than anyone else, about ten times a year or so. Our parents seem to get colds less often than we do, only about 4 or five times per year. Sometimes it’s worse than others, and we are given antibiotics. We take them because our parents give them to us. And they give them to us because our family doctor tells them to. We get loose stools for a while, and we don’t understand why. After some time, things kind of get back to normal.

We go on like this for years. Actually, usually for at least two or three decades. Everything we do destroys our gut flora. All the foods, the chemicals, the drugs, destroy the essential health-promoting bacteria and the balance between the different varieties that are meant to populate the gut, and at the same time promote the overgrowth of specific kinds of pathogenic bacteria and yeasts that take over our gut.

All the foods we eat are loaded with lectins that damage the lining of our gut, making it thinner, less functional, less protective, and more vulnerable to further damage. This damaged gut with its damaged lining and damaged glycocalyx becomes leaky. Not only do we not digest food properly, not only do we not absorb nutrients properly, not only do we not excrete wastes properly, but all sorts of stuff starts leaking from our gut into our blood. And possibly the worst thing that can happen is to have a leak into our bloodstream of undigested proteins.

The reason is that undigested proteins in the blood trigger the immune system that responds to them as allergens. As this is the result of a degenerative process, and is therefore a chronic condition that grows more severe with time, the dysfunction eventually manifests itself into auto-immune disease conditions. Those ‘incurable’ disease conditions on which modern conventional medicine has given up. This is how serious it is.

Proteins from out food are not meant to enter the bloodstream—ever. So much so that the kidneys will completely clog themselves up trying to remove proteins from the bloodstream to the point of kidney failure. Proteins are meant to be broken down into the much smaller units of which they are made called amino acids. And breaking down proteins into amino acids is meant to be done by the stomach before entering the intestines. Hence, having not fully broken down proteins in the gut can only really happen if they haven’t been broken down while they were in the stomach. Clearly, it isn’t therefore only the gut that is dysfunctional and damaged: the stomach must also be dysfunctional in some way to allow these undigested proteins to pass into the intestines in the first place.

We have previously looked in detail at the process of digestion in Understanding digestion. The essence of what we need to know is that the stomach has specialised cells whose purpose is to secrete hydrochloric acid to break down proteins; that acid is produced when these cells detect the presence of protein in the stomach; that as proteins are broken down, the pH rises and the stomach secretes more acid to keep the pH low in order to continue breaking down the protein; that when the pH stays low for a few hours or so, this signals that all the proteins have been properly broken down, and that the chyme (the processed contents of the stomach) can be transferred to the small intestine; and that at which point the stomach valve opens, the acidic chyme moves through, and the pancreas injects into the small intestines a concentrated solution of bicarbonate to neutralise the acid which would otherwise damage the lining of the intestines. This is how it’s supposed to work.

But if there isn’t enough bicarbonate in the system, the pancreas cannot do this properly. If there isn’t enough water, the pancreas cannot do this properly. If the stomach doesn’t produce enough acid, the proteins are not broken down properly. And if the acid producing cells of the stomach are not regularly exposed to high concentrations of hydrochloric acid, they lose their ability to produce it. This happens when little or no concentrated sources of protein are eaten, like when we are vegetarian or vegan for a long time. But it also happens when the lining of the stomach, which is supposed to be protected by a thick layer of mucus while digesting protein, is instead exposed to and damaged by its own hydrochloric acid. This happens when there isn’t enough water to make that protective layer of mucus, and it is why we should drink water before meals.

So, here’s what we get: not enough water or bicarbonate—loss of acid-neutralising function of pancreas, and damage to intestines; not enough protein in the diet—loss of acid production ability, and undigested proteins; not enough water—damage of stomach lining, loss of acid production ability, and undigested proteins; undigested proteins—chronic immune response to circulating allergens and autoimmune disease conditions. This is compounded with the damage that results from exposure to chemicals and antibiotics, from the overload of sugars and starches, and from the destruction of the cells lining the gut by the lectins in our diet.

The end result is, as expected, precisely what we observe: a population where basically everyone has, to some extent, compromised digestion, and therefore, a population where everyone is, to some extent, sick. Because we don’t know any of this, because we don’t know how food affects the body, because we don’t know how the organs of the body function, because we don’t now how digestion works, and because nobody else around us knows any of it either, we believe everything is normal and everything is just fine, just as it should be, just as it always has been. But the truth is that it isn’t.

What’s actually hard to believe is how simple the solution is: 1) avoid as much as possible exposure to chemicals and antibiotics, and adopt measures to systematically help the systems of the body cope with and recover from the exposure we cannot entirely avoid; 2) avoid as much as possible the overload of sugars and starches, and focus on animal protein and fats from free range animals, and green vegetables. This will automatically lead to a nutrient-dense, whole foods diet that also minimises exposure to gut-damaging lectins; 3) drink plenty of clean water to ensure good hydration, especially with enough time to replenish the stomach’s and pancreas’s reserves before meals, and take a little extra bicarbonate on an empty stomach with your first glass of water in the morning to maintain a good alkaline buffer and balance.

 

This strategy is so simple, and yet it is both preventative and curative. The extent to which we need to be strict depends on the extent of the damage from which we need to recover. And as it true for everything, it’s far easier to prevent damage than to recover from it. That’s obvious but it’s good to remind ourselves of it when our motivation weakens or strength of will falters. The amazing news is that, as shown by doctors Terry Wahls and Steven Gundry who specialise in the treatment of autoimmune disease conditions, recovery from even the most severe cases is virtually guaranteed and only a matter of consistency, patience, and time. I hope this is enough of a motivation for you. Enough of a motivation to at least start to make the effort to regain and then preserve the health of your gut and digestive system—the system on which everything about your health depends.

Oh, and breakfast? Just skip it and have your first meal at lunchtime. Breakfast is not, as we have been told over and over again, the most important meal of the day. It’s actually the most important meal of the day to skip. We’ll get back to this point some other time.

 

Thank you to all our patrons, and in particular Eric Peters, for their continued support. Become a proud sponsor of healthfully and join our patrons today!

Every undigested protein is an allergen

If someone asked you what you thought was the most fundamental, the most essential, the most important health challenge that we face as modern human beings living in industrialised countries, what would you tell them?

Take a moment. Shift your gaze away from this text, and think about it.

When we read or hear something about health and nutrition in the news, on websites, on blogs, on social media, or even in books, the information we encounter is almost always biased and directed  in some way. It is also always restricted in scope. In fact, it is usually very restricted in scope. All this is perfectly natural and expected: whenever we sit down to write, it is usually about something in particular, something specific, some topic we want to address or explore. It’s hard to think of circumstances where this would not be the case.

Moreover, basically everybody who writes anything, does so in order to be read, and therefore naturally attempts to appeal as much as possible to their readership, both in content and in style. But maybe the most influential factor is that we have grown accustomed to information packets, to bite-size bullets of information: quick-to-read, quick-to-scroll-through, and quick-to-either-share-or-forget. And this has above everything else shaped the way information is being presented by all those people out there trying to appeal to more readers. Little can be done to counter this tendency. It’s just how it is at this time.

As a consequence, for all these reasons, we are—the whole world is—migrating away from the mindset that encourages inquiry into the global, the general, the underlying aspects of things. Instead, we are migrating towards an evermore concentrated, focused, laser-beam approach to basically everything. This is true in all fields of study and inquiry to some extent. In matters of nutrition, it is particularly noticeable, and the reason is surely at least in part because we tend to be at the same time very interested and highly sensitive to advice about what we should or should not eat. We take such advice very personally, and often react strongly to it.

Our relationship to food is very deep because it is so constant and continuous, so intimately related to our survival. This relationship starts when we come out of our mother’s womb, and persists throughout each day, every day of our life, until this life of ours itself comes to an end. What in addition makes this relationship so close and so intense is that if we don’t drink or eat, usually even for a few hours, we get headaches and stomach aches, we get light headed, weak, and unable to concentrate and function, we get grumpy and irritable. It is very clear and naturally understandable that we therefore tend to be—that we are—very sensitive to advice about what to eat, but immensely more so to advice about what not to eat, especially if we happen to eat those foods about which the advice is given.

Hence the movement to superficial, non-contentious, bite size bullets of information: ‘blueberries are excellent: they are low in sugar and full of antioxidants’; ‘avocados are amazing: they are not only full of healthy fats but they are also alkalising’; ‘hydrogenated vegetable oils are very bad: they are full of toxic trans fatty acids.’

But what about the essential, the fundamental, the underlying aspects of things?

You have had more than a few minutes to think about it. What would you say, then, to this question of what is most fundamental to the health, to what constitutes the most fundamental health challenge we face? I would say it’s digestion.

Digestion is where everything about us begins and ends. It is in and through the digestive system that we absorb all the nutrients from our food and excrete all solid wastes. It is through the digestive system that we absorb all the constituents of everything that we call body, and excrete all that is toxic, be it produced from the environment or from within through healthy digestive and metabolic processes. Do you find this sufficient to illustrate why digestion is so fundamental? For me it is. But we can go a lot further.

Evolutionary considerations, arguments, and observational evidence, are always useful, and usually very powerful in guiding clear thinking about matters of health. One of the main questions that has and continues to preoccupy evolutionary biologists is that of the growth of the human brain. In this, one of the most compelling ideas put forward to explain its evolutionary history is called The Expensive Tissue Hypothesis. I plan to, in the future, devote much more time to it. But I must refer to it here because of its relevance to digestion.

The Expensive Tissue Hypothesis is based on the fact that there is a strict minimum to the amount of calories any animal requires to survive, the observation that the brain is the most metabolically expensive organ in the body, and the conclusion that it would be very hard for any large complex animal to sustain two systems as energetically expensive as the brain. Because the gut is the second most metabolically expensive, and because both the brain and gut together account for a disproportionately large fraction of the body’s caloric needs, an increase in the size of the brain would necessarily be at the expense of that of the gut, and vice versa. It simply would not be possible to sustain both a large brain and a large gut. And thus, the growth of the brain would have to be accompanied by a shrinking of the digestive system. This is what is observed.

However, it is important to emphasize that it is the shrinking of the digestive system that allowed for the growth of the brain; not the growth of the brain that precipitated the shrinking of the gut. The growth of the brain would only be possible with a surpluss of calories for it to growth and have its increased activity sustained. It is even more important to emphasize that this evolution was the unintended consequence of a shift from a high-fibre, nutrient-poor, plant-based diet, to one consisting mainly of low-fibre, nutrient-rich, animal-based foods.

Number two Silverback Mountain Gorilla (Gorilla gorilla beringei) of Kwitonda Group, Akarevuro, Virunga Mountains, Rwanda

Male mountain gorilla of the berengei berengei subspecies of eastern gorillas in Ruanda (Source: Time). As you can see from the chest muscle definition, this adult male’s bodyfat is low. The huge bulging belly that is apparent when they are seated and relaxed is the consequence of having it hold the very long gut required to process each day approximately 20 kg of fibrous roots, leaves, and stocks of the plants they eat.

It is very interesting—and it is surely related to this evolutionary history—that the gut has by far the largest number of nerve endings, second only to the central nervous system. Moreover, unlike other organs and systems of the body, all of which are entirely controlled by the brain, it is the only one with directive nervous signalling to the brain. Because of this, it is the only organ with a direct influence on the brain. Thus, besides the physical implications, some of which we’ll explore soon, it is quite literally the case that a happy gut means a happy brain. And conversely, a sad, unhappy, depressed brain is very likely to be caused by a dysfunctional gut.

It is a sick, dysfunctional, damaged gut that is the primary characteristic underlying states of disease. This is why I would say that it is a sick, dysfunctional, damaged gut that is the most fundamental health challenge we face today as modern human beings.

I know this might leave you hanging. Especially because we have not yet made any reference to the title. But I promise, we’ll pick up from here next time.

 

Thank you to all our patrons, and in particular Eric Peters, for their continued support. Become a proud sponsor of healthfully and join our patrons today!

Understanding the role of vitamin K-dependent proteins in vascular calcification

What if the process of arterial calcification was regulated from within the cells of the blood vessels, and that it had nothing directly to do with what you ate and what circulated in the bloodstream because calcification takes place not anywhere near the surface but inside the blood vessel wall?

What if the process of arterial calcification was actually a process by which muscle is transformed into bone, a process by which vascular smooth muscle cells transform themselves into bone cells which then actually build bone tissue within the blood vessel wall?

And what if apoptosis preceded calcification, what if cell death was what triggered the process of calcification, and it was the apoptotic bodies of dead vascular smooth muscle cells within the blood vessel wall that served as the nodes around which calcium crystals formed?

Would you not find this shocking? Find it incredible that any of these could be true, let alone all of them? It’s entirely not at all what we’ve been told by “health experts” and “health authorities” for more than half a century!

All of these statements are hard to believe. It is especially unbelievable that muscle cells can change into bone-building cells, and begin to grow bone tissue within the artery wall. It sounds surreal, kind of like science fiction. But it isn’t. All of it is true. All of this has been observed.

Interesting, you may think, but what does any of this have to do vitamin K? Everything! It has everything to do with vitamin K.

How clever we are

The sophistication and precision of biochemical reactions and processes in animals and humans are mind blowing. Understanding how they work is a wonderfully noble endeavour that is certainly very fulfilling in its own right. In some cases though, it can be a matter of life and death. And in the case of the processes related to and regulated by vitamin K dependent proteins it definitely is.

This is not an exaggeration to push you to read on. It’s a statement of fact. And you’ll see how this is true by the time we finish. I believe it is essential, for each one of us to understand the details of how things in our body work and how they are related and connected in order to appreciate their significance and their importance.

We are so clever. We can figure out such complicated things when we put our minds to it. Things like complex biochemical pathways, or long chains of enzymatic reactions that, one step at a time, transform molecules from one form into another. And it is this kind of cleverness that has enabled us to develop the hundreds of different types of medications we can find today in drug stores.

We have designed medications to address basically every symptom we can think of. If it’s a symptom we’ve had, it’s most likely a symptom that many others have or have had. And if many have the same or a similar symptom, we can be sure that at least one pharmaceutical company will have made a drug for it.

Warfarin was developed in the 1950s to prevent or at least suppress coagulation, and in so doing help prevent or at least reduce the number of strokes and heart attacks. Because so many people either suffer from, are susceptible to, or are at risk of cardiovascular disease, many people take warfarin.

And what I mean by many in this case is between 20 and 30 million prescriptions per year in the United States alone. The number went up to 35 million in 2010 and dropped back to 20 million in 2015. That’s a lot of warfarin pills! You can see the stats here (http://clincalc.com/DrugStats/Drugs/Warfarin). Warfarin is in the top 50 drugs. It’s 42nd down the list. Just below aspirin at 39, insulin at 36, and ibuprofen at 34, as you can see here (http://clincalc.com/DrugStats/Top200Drugs.aspx).

Surely close to every household in the western world will have somewhere in a bathroom cupboard or drawer a bottle of aspirin or ibuprofen. Given how close to warfarin they are in popularity of usage, there’s clearly no need to even say that this anti-coagulant drug is in broad and widespread use.

Isn’t this great, though? Millions of people at risk of having blood clots that would possibly cause them a stroke or heart attack, protected by taking a little warfarin every day? Yes, I suppose in some ways, it is, if these people are actually at risk. But, unfortunately, with a drug like that, we can be pretty sure that most are taking it preventatively, as in, just in case. And this is a problem.

Warfarin works by disrupting the process that leads to the activation of coagulation factors. The blood’s ability to form clots quickly is one of its most vital functions, because without it we would just bleed to death from a flesh wound. Evolutionarily, we simply would not have made it to here without this protection mechanism that ensured that when we were wounded, the blood would immediately thicken to stop it bleeding out of our body by forming clots at the surface of the open wound as fast as possible. The special proteins responsible for regulating coagulation are vitamin K-dependent proteins (VKDPs).

It has taken a long time to understand, first of all, that there wasn’t just vitamin K, but in fact two different kinds of vitamin K. It is also true that it has taken a long time to identify the major vitamin K-dependent proteins and figure out how they work. We are talking about 40 years from the 1950s to the 1990s. So, you really shouldn’t be surprised if you haven’t read or heard about this before.

But today, a lot has been understood through in vitro and in vivo observations, trials and studies both in animal models and in humans. And even though we will inevitably continue to deepen our understanding of the subtleties of the molecular mechanisms, the species, and the interactions involved in the life of cells and proteins in how they affect the state of our blood vessels and organs, this is a sketch of the picture we have at this stage.

Vitamin K dependent proteins

There are about twenty identified VKDPs belonging to two classes: hepatic—those produced by the liver, and extra-hepatic—those produced in other tissues. Those from the first class are the most well-known and well-studied. They are the coagulation factors (II, VII, IX, and X) manufactured by the liver and activated within it before being pushed into the bloodstream and circulated throughout the body to maintain a healthy coagulation response in case it is ever needed. These are the ones targeted by warfarin. Naturally, since that drug has been around since the 1950s, the role and function of these vitamin-K dependent coagulation factors have also been known at least since that time.

The second class is less known and less studied but has—luckily for us—gained much more attention in the last two decades. It includes three very important proteins whose functions are essential in maintaining healthy blood vessels. But unlike the coagulation factors produced in the liver, these proteins are instead produced by the vascular smooth muscle cells and activated there locally in the vasculature. These vascular health factors, we call them that in analogy to but to distinguish them from the coagulation factors, were identified much more recently in the 1980s and 1990s. All are proteins that contain gamma-carboxyglutamic acid abbreviated Gla.

Some important ones for us here are osteocalcin, for which it took 30 years to be identified as an inhibitor of calcification when it was discovered in vitro to prevent the precipitation of crystals in a supersaturated calcium solution. This means that without it, calcium crystals would have inevitably formed spontaneously in the solution. Osteocalcin is also called bone Gla protein. Growth arrest specific protein 6 is involved in the regulation of cell proliferation, and seems to inhibit premature cell death. And the most important one in relation to soft tissue calcification, matrix Gla protein abbreviated MGP.

Matrix Gla protein was originally isolated from bone, but it has been found to be expressed in several other tissues including kidney, lung, heart, and—most critically—vascular smooth muscle cells or VSMCs. It is now known to be the most potent inhibitor of calcification of blood vessels, and even though the liver does produce and secrete MGP into the bloodstream, only the MGP produced in the vasculature inhibits calcification.

Besides being produced in different tissues, another important difference between the two classes of VKDPs is that the liver-produced coagulation factors are phylloquinone—or vitamin K1-dependent, whereas the vascular smooth muscle cell-produced proteins are menaquinone—or vitamin K2-dependent. In light of the fact that it is rather hard to find vitamin K1 insufficiency with a diet that contains at least some green plant foods, while the exact opposite is true for vitamin K2 of which the western diet is practically devoid, this difference is highly significant.

Both vitamin K1 and K2 are absorbed in the second and third portions of the small intestine, the jejunum and ileum, K1 is delivered to the liver, whereas K2 is transported via LDL and HDL to other organs. K1 is mainly found in the liver, whereas K2 is preferentially stored in peripheral tissues, with the highest levels in the brain, aorta, pancreas, and fat tissues. This obviously attests to the importance of these essential vitamins.

While vitamin K1 and K2 are really two different vitamins with different functions, transport mechanisms, and distribution in the tissues, and while there are several differences between the vitamin K1-dependent and the vitamin K2-dependent proteins, these have one essential thing in common. This is, as their name says, that they are vitamin K-dependent. What this means is that all these proteins share the same enzymatic chain of activation—whether it mediated by K1 or K2—that transforms them into their biologically active form, the form they need to have in order to do the things they are meant to do.

All VKDPs must be carboxylated in order to be activated. The process is complicated and not yet completely understood. We know that it is targeted to the glutamic acid (Glu) residues on the protein that must be made into gamma-carboxylglutamic acid (Gla). We also know that the process is mediated by the enzyme gamma-glutanyl carboxylase (GGC), and that vitamin K is the main co-factor that enables the enzyme to perform the activation. In the end, the process leads to the addition of a carbon dioxide molecule to the gamma-carbon of Glu, which transforms it into Gla. However, it is the reduced form of vitamin K that is required.

Vitamin K, whether it is the plant-based phylloquinone (K1) or the animal-based menaquinone (K2), enters the body through the diet in its non-reduced form. Reduction involves the addition of hydrogen in molecular form, H2, to make KH2. Transformations of this kind are generally always done by enzymes, and so is this one. In this case the enzyme is vitamin K epoxide reductase (VKOR). Its action is essential because it is the reduced form KH2 that acts as the co-factor in the process of carboxylation.

The energy released by the oxidation of KH2 drives the addition of the carboxyl group unto the glutamic acid residues. But the oxidised form of vitamin K, KO, can subsequently be reduced again to KH2. Thus vitamin K is first reduced, then oxidised to help push the carboxyl group unto the glutamic residue, and then reduced once more to start the whole cycle again. This cycle is called the vitamin K epoxide reductase or VKOR cycle.

For this class of proteins, the VKDPs, activation through carboxylation means for them to acquire the structure and properties needed to bind calcium in order to transport it. You may recall from a previous chapter in the story of vitamin K2, matrix Gla protein generally transports calcium out of soft tissues in order to prevent calcification, and bone Gla protein generally transports it into bones and teeth to prevent osteopenia, osteoporosis, and tooth decay.

The big red flag

Now you understand why it is that when, in our remarkable cleverness, we understood that the main coagulation factors depended on the action of these enzymes to be activated and rendered functional, we naturally concluded that the best way to prevent clot formation would be to prevent coagulation, and that this could be achieved by blocking these enzymes from doing what they are intended to in a healthy organism. This is precisely what warfarin does.

And it does it well. Otherwise it wouldn’t have become as commonly used as it is. And we can be certain it has saved a lot of people much of the pain and possibly life-threatening conditions that a blood clot could have caused them. The problem is that the vascular health factors so critical for maintaining healthy blood vessels, depend on the same enzymes for activation as do the coagulation factors. Preventing the carboxylation of coagulation factors, prevents, in exactly the same way, the carboxylation of the vascular health factors.

This was only understood to be a major problem relatively recently. We first had to understand that there isn’t just one kind of vitamin K, but that there are two, and that they are very different in their functions. We had to understand that both vitamin K1 and vitamin K2-dependent proteins rely on the same enzymes to get activated. We had to understand the carboxylation process by which they are activated. And we had to understand that MGP, BGP, and Gas 6 are vitamin K-dependent proteins, that they are specifically vitamin K2-dependent, how they are activated, what they actually do in our veins and arteries, and what happens if they can’t do what they are designed to do.

A major red flag about anticoagulants and warfarin came up from what was seen in mice. The first part of the study was with MGP-knockout mice, (mice in which the MGP-encoding gene was deactivated). They were observed to have stunted growth from the premature calcification of the epiphysis—the part at the end of bones and at the junction with the cartilage of the joint which allows the bone to grow longer. As as soon as the epiphysis calcifies, longitudinal growth stops. But this was the least severe of the problems that were observed.

The MGP-knockout mice very quickly developed severe arterial calcification, and died highly prematurely, within 6 to 8 weeks, of strokes, heart attacks, and rupture of the aorta. Normal lab mice live 2 to 3 years and some even up to 4 years. So, in the least extreme case, a MGP-knockout mouse dying from aortic rupture at 2 months instead of living a relatively short normal life of only 2 years, would be equivalent for a human that would normally live to the age of 72 to die at the age of 6!

Here is what severe coronary calcification looks like in humans:

severe_coronary_calcification

Severe coronary calcification in a patient with end-stage renal disease. We can see that these blood vessels are basically filled with bone tissue that appears bright white. (https://www.bmj.com/content/362/bmj.k3887)

It was also observed that although the liver did produce and release MGP into the bloodstream, it had no effect on the arteries. Only the tissue-specific, locally-produced MGP within the vascular smooth muscle cells was able to inhibit calcification.

To check these conclusions, a similar study was done on normal mice that were given vitamin K1 to ensure proper liver function and healthy coagulation, and warfarin to block all extra-hepatic MGP action in tissues. The result? Stunted growth, pervasive arterial calcification, and premature death from stroke, heart attack, and aortic rupture.

The conclusions were solid: matrix Gla protein is the organism’s primary protection against soft tissue and arterial calcification; liver MGP has no protective effect on arteries, and only VSMCs-produced MGP can inhibit calcification in the arteries; both vitamin K deficiency and disruptions of the action of the enzymes that activate MGP cause extensive soft tissue calcification; and only vitamin K2, not vitamin K1, can inhibit warfarin-induced calcification.

Going further

When this was understood, more attention began to be paid to matrix Gla protein. Many other details were elucidated through further investigations. It was found that MGP is an 84-amino acid protein with five Gla residues. That all of these Gla residues are produced by gamma-carboxylation, which is mediated by the enzyme gamma-carboxylase that requires vitamin K2 as a cofactor, and that until now, the only known function of Gla residues is to bind calcium ions and crystals (calcium apatite). It was discovered that the concentration of calcium and phosphate in extracellular fluids is high enough to trigger and sustain growth of crystals, but that MGP and BGP prevent this from happening. That MGP is required by VSMCs to maintain their elastic and contractile nature. And not just that.

MGP actually inhibits the transformation of VSMCs into bone cells by antagonising the action of Bone Morphogenic Protein 2 (BMP2). It turns out that the muscle cells of the blood vessels have in them the potential to either stay smooth elastic contractile muscle cells, or turn into osteoblast-like bone building cells. BMP2 triggers that osteogenetic gene expression in the VSMCs: it tells muscle cells of the blood vessels to transform into bone-building cells.  And as if this wasn’t enough, BMP2 also induces apoptosis: it tells blood vessel muscle cells to commit suicide, which is certainly to help in the process given that once dead, they can be used as seeds for calcium crystal formation, and thus promote a faster and more efficient calcification.

What induces expression of BMP2 in cells? Probably several things that we haven’t yet identified. But for now we know that BMP2 is stimulated by oxidative stress, chronic inflammation, and high blood sugar levels. The good news is that MGP protects against all of these effects by antagonising BMP2. So if there is enough MGP and enough vitamin K2, if there are no disruptions to the action of the vitamin K dependent enzymes by anticoagulants like warfarin, and if oxidative stress, inflammation, and blood sugar are kept low, then there is protection against calcification of the arteries and other soft tissues like the liver, kidneys, and heart.

Recap

Here we have it. We have now understood the role of vitamin K dependent proteins in vascular calcification. And although it was a little long and maybe somewhat arduous, all the details are clear. It is complicated. I won’t deny that. But I have strived to make it all as accessible as I could without diluting the mechanisms of action and relationship between the different players. Let’s recap to make sure you are left with the essential elements in mind.

Vitamin K dependent proteins can either be vitamin K1 or vitamin K2 dependent. The dependence comes from the fact that vitamin K is required to activate the protein. This activation is the carboxylation in which a carbon dioxide is added to the glutamic acid residues along the protein. Carboxylation is mediated by carboxylase (GGC) that requires the reduced form of vitamin K in order to oxidise it and get the energy to push the carbon dioxide molecule onto the glutamic acid residue. Vitamin K is reduced by reductase (VKOR) which can do it over and over again in what is called the VKOR cycle.

Vitamin K1 dependent proteins are mostly liver based coagulation factors. Vitamin K2 dependent proteins are mostly outside the liver and generally involved in inhibiting soft tissue calcification. The most important calcification-inhibiting VKDP is matrix Gla (MGP), which performs a wide range of tasks to maintain elastic, flexible, calcium-free blood vessel walls.

Calcification is triggered by the death of vascular smooth muscle cells. These dead muscle cells act at seeds for calcium apatite crystals to form. VSMCs can be induced to become osteoblast bone-building like cells that then go on to stimulate the growth of bone tissue within the artery walls. This process is stimulated by bone morphogenic protein 2 (BMP2), which is expressed under conditions of oxidative stress, inflammation, and hyperglycaemia.

To prevent and reverse calcification the most important is to provide a good supply of vitamin K2 through diet and supplementation. Because it is essential in the activation of Gla proteins but only through its role in the VKOR cycle, the amount of K2 is the rate limiting factor. Hence more is better than less, and excess will simply remain unused but will not cause harm.

Naturally, matrix Gla protein needs to be available. Cells of tissues where calcification occurs (kidney, liver, heart, and blood vessels) secrete MGP. An interesting evolutionary self-protection adaptation mechanism. And here’s another: the amount of MGP that is produced by a cell depends on at least two factors that have been identified. One is the amount of calcium; the other is the amount of vitamin D3. In both cases, the more there is, the more MGP is produced.

So, vitamin D3 has the role of making calcium available but at the same time stimulates the production of MGP in order for the calcium to be available to the bones and not to the soft tissues. But for this, it relies on vitamin K2. This is why vitamin D3 without vitamin K2 leads to calcification: because MGP and BGP remain inactive and incapable of binding to the calcium ions to move them into bones and out of tissues. On the other hand, plenty of vitamin K2 would indeed activate the available MGP, but without enough vitamin D3 there might not be enough MGP to confer proper protection against calcification. This is a perfect example of the complementarity of action and function in essential micronutrients. There are certainly many more, but this one is particularly remarkable.

Final thoughts

I want to close on a final consideration. It is so easy and seems so natural for us to think in terms of this and that, good and bad, for and against, that our tendency is to look at everything in these terms. This is also true when we look at biochemical processes like the ones we have described and explored here. We naturally lean towards looking at the calcification inhibiting mechanisms as protective, and those that promote calcification and apoptosis as destructive.

But the reality is that cells, proteins, and enzymes don’t behave in these terms, they don’t think in these terms simply because they don’t think. They react biochemically to what they are exposed to, to the molecules and chemical messengers they encounter, to the quality of the liquids in which they bathe, to the characteristics of the environment in which they live, microsecond after microsecond, without any forethought or concern for the microsecond that will follow. The only guiding principle that can be used to lead us to understand why things happen the way they do is evolutionary adaptation to survive.

Having recognised this, we immediately see that the mechanisms that promote apoptosis of VSMCs, their subsequent transformation to osteoblast-like cells, and the growth of bone tissue within the artery walls that we refer to as arterial calcification, can only be a protection mechanism. A mechanism to protect the tissues and cells from the damaging effects of exposure to free radicals, inflammatory molecules, and glucose. Because, as we have seen, the process is reversible, it would be perfectly natural to undergo periods of calcification followed by periods during which the bone tissue is broken down and removed from our arteries and other soft tissues and organs when the circumstances allow it. Actually, we should say when the circumstances dictate it, because no matter what happens, it is always the circumstances—the environment—that dictate what is to happen.

What we can do, with the knowledge of what we have understood, is make choices about what we eat and drink, when and how much we eat, and how we live, sleep, and exercise. Choices that will shape or reshape, define or redefine the makeup of this internal environment of the body to always move us in the direction of optimal biochemistry, optimal physiology, optimal metabolism, and optimal health.

Everything that we explore together is always about just this. But sometimes the corrective action requires effort, sometimes even a lot of effort. In this case, however, it is as simple as can be, because it only requires us to supplement with vitamin K2 and possibly also D3. Of course, the last thing we want is a lifestyle that promotes the expression of BMP2 and the growth of bone tissue within our arteries. But supplementing with K2 and D3 together will in general bring only benefits. I know it was a very long-winded way to get to this, but now you understand why. That was—and is—the whole point of this blog, after all. I hope you enjoyed reading.

 

The information in this article comes primarily from the following papers: Molecular Mechanisms Mediating Vascular Calcification by Proudfoot and Shanahan (2006); Vitamin K-dependent Proteins, Warfarin, and Vascular Calcification by Danziger (2008); The Role of Vitamin K in Soft Tissue Calcification by Theuwissen, Smit, and Vermeer (2012).

Thank you to all our patrons, and in particular Eric Peters, for their continued support. Become a proud sponsor of healthfully and join our patrons today!

Insulin and Triglycerides

Every time I review someone’s blood test results, and then discuss with them what they mean and what they should do to improve their numbers, there’s something I almost always have to explain. And this was the relationship between fasting insulin and triglyceride levels.

Take a look at this plot:

trigs_vs_insulin_gb

Plot showing ten pairs of measurements of insulin and triglycerides, made from the same blood samples. They were collected between 2011 and 2017, and all are from my own blood tests.

It shows measurements of insulin concentration on the horizontal axis in mili units per millilitre (mIU/ml), and triglyceride levels on the vertical axis in milligrammes per decilitre (mg/dl). This is a correlation plot in which independent measurements of one variable are plotted against independent measurements of another in an attempt to see if there is a relationship between them.

Is there an order in the way the dots are organized? They are clearly not randomly distributed as a circular cloud of dots—it would mean that there is no relationship. Instead, we see what looks like a linear relationship in which lower values of insulin correspond to lower values of triglycerides, and higher values of insulin correspond to higher values of triglycerides. It’s not a straight line, but it’s definitely a clear linear relationship, and the value of the correlation coefficient, which quantifies how tight the relationship actually is, of just under 0.9 is pretty close to 1. In other words, it’s a pretty tight linear relationship.

Triglyceride is a fancy word for fat or lipid, because fat molecules are composed of three fatty acids held together by a glycerol structure. This is what triglyceride refers to. The amount of fat in the blood is affected by the amount of fat we eat, and the amount of body fat we have. Naturally, after a fatty meal, triglyceride levels will increase as the fat goes from the digestive system into the blood, they will reach a maximum, and then start to go down. The longer we wait before we eat again, the lower they will go. But there’s a few complications.

The first is that depending on the amount of insulin, one of whose jobs it is to transport nutrients into cells, whatever is circulating in the blood—and this includes glucose, of course, but also protein and fat—will in general be stored away faster if insulin is higher, and slower if insulin is lower. This means that if you eat fat together with sugar or starch, the whole lot will be packed away, and mostly as fat, minus the little bit of glucose your muscles and liver have room to store up as glycogen.

The second is that depending on the state of insulin sensitivity—the fundamental parameter that determines how well or poorly cells can use fat for fuel—triglycerides will in general be used up faster if we are more insulin sensitive and slower if we are more insulin resistant. This means that in the morning, twelve to fourteen hours after having had the exact same meal, the more insulin sensitive person will have lower triglyceride levels than the more insulin resistant.

And in fact, no matter if we have a measure of fasting insulin or not, and no matter how little we know about the person’s overall health, fasting triglyceride concentration is probably the best general marker of insulin sensitivity. Nevertheless, because their levels fluctuate quite a lot over the course of each day as a function of what we eat and drink, it is true for triglyceride levels as it is true for many other blood tests that are affected by the kind and amount of food and drink we’ve had over the last days, and most importantly by the amount of sweet or starchy carbohydrates.

Now, take a look at this second plot:

trigs_vs_insulin_final

Plot showing, in addition to the 10 points shown in the first plot (in red), another 20 pairs of measurements of insulin and triglycerides, also all from the same blood samples, but from seven other persons.

It shows the same 10 data points shown in the first plot from my own results, but with another 20 pairs of measurements taken from other people that I’ve coached and helped with the interpretation of their results. You can see that the relationship is better defined because of the additional points that now together cover a wider range of values on both axes.

However, you can also see that, the relationship is not as tight. In particular, there are a few points that are quite far off the main trend—mostly those at the top of the plot with high triglyceride and low insulin values. We see how these off-trend points affect the tightness of the relationship seen in the initial data set when we compare the values of the correlation coefficients. These off-trend points lead us to the third complication I wanted to bring up.

But first, please take a minute to consider the matter: What could lead to having low insulin and at the same time high triglycerides? What could be the cause of the difference between my numbers, which did contain some very low insulin levels, but all of which were paired with equally low triglyceride values, and this other person’s numbers? What causes insulin to go down? What happens when insulin is low? What could cause triglycerides to go up while insulin is low?

Insulin, no matter how high it is, will start to go down when we stop eating. The longer we fast, the lower it will go. Each person’s baseline will be a little different depending mainly on their metabolic health and their body fat stores. The more efficient the metabolism is at using fat for fuel—the more insulin sensitive, the lower insulin will go. But also the lower the body fat stores are, the lower insulin will go. On the flip side, the more insulin resistant and the fatter we are, the longer it will take for insulin to drop and the higher it will stay at baseline.

This is pretty shitty. I mean, as we develop insulin resistance, average insulin levels will become higher and higher. As a result we’ll store calories into our growing fat cells more and more easily, and will therefore become fatter and fatter, faster and faster. But fat cells also secrete insulin! So, the more fat cells there are, the higher the insulin levels will be, and the harder it will be to lower our basal insulin. To burn fat, we need to lower insulin levels. The fatter we are, the higher the insulin levels will tend to be. And the fatter we are, the harder it will be to lower insulin levels.

It’s a bit of a catch, but in the end, it’s not such a big deal because basically everyone who is overweight and who starts to fast and restrict carbohydrates melts their fat stores away very well. It works incrementally: insulin goes down a little, insulin resistance is reduced a little, fat-burning starts; insulin goes down a little lower, insulin resistance is further reduced, fat-burning increases; and on it goes, until we have lost all those extra kilos of fat that we were carrying on our body, be it 5, 15, 20, 35, 60 or even 100 kg of fat! It’s just a matter of time.

Now, after this little tangent on insulin and fat stores, we can come back to those anomalous points in the plot, the most conspicuous of which is the one just below 120 mg/dl of triglycerides but only 3 mUI/ml of insulin. Have you come up with an explanation? Here is mine:

That point is from one of my wife’s blood tests. It is unusual because it was done after 24 hours of fasting. My 24-hour fasting blood test done a number of weeks before, and my numbers were 41 for trigs at 2.3 for insulin. The difference between her and I was that I was already very lean, whereas she wasn’t. Therefore, as she fasted, her insulin levels dropped very low, and then the body started releasing its fat stores into the bloodstream in high gear. This is why her triglyceride levels were this high while her insulin was that low. It’s almost certainly the same for the other two points up there with trigs at 110 and 90 with insulin around 4 and 2.5 (the latter one of which is also my wife’s).

Since we did many of our blood tests around the same time, there are 9 data points from her on the plot. Several are in the centre of the main trend at insulin values between 6 and 7, but I’d like draw your attention to her lowest insulin value that was measured at 1.8, and at which time her trigs were at 57, and her lowest triglyceride level of 48, at which time her insulin was at 2.2. This shows that on average her values are a little further along the trend than mine are because of the small difference in body fat, but that she has good insulin sensitivity, and a well-functioning metabolism that can efficiently use fat for fuel.

The other off-trend point, but in the other direction on the right hand side, with insulin just above 10 and trigs around 65, is from my mother’s first blood test which I ordered and included insulin and trigs, before I got her off carbs. She was 82 at the time, eating a regular kind of diet, but not a very nutritious or varied diet with plenty of bread and cheese, because she had serious problems moving around and taking care of herself while still living alone. And so, it’s just the result of being older, having plenty of carbs, but not being highly insulin resistant nor highly overweight. Her baseline insulin levels were just generally higher because of her age and diet, but her trigs weren’t excessively high.

However, after just four days of intermittent fasting on a very low carb regime with most calories coming coconut oil spiked green juices and coconut milk smoothies, her insulin went from 10.3 to 4.7, and she lost 5 kilos, which, of course, were mostly from the release of water that the body was retaining to counter the effects of the chronic inflammation that immediately went down with the very-low carb regime and fasting.

Later, having sustained this strict green healing protocol for about 6 weeks, her numbers were at 2.9 for insulin and 56 for trigs. And by then she had lost another 5 kg, but this was now mostly fat. She had, at that point, recovered full insulin sensitivity, had lost most of her body fat stores, and overhauled her metabolism. She was 83 at that time, which shows that this sort of resetting of the metabolism can work at any age.

On this note, let’s conclude with these take-home messages:

First, the next time you get a blood test, request that insulin and triglycerides be measured, because it’s the only way to know what your fasting insulin actually is, and because it is very telling of your level of insulin resistance or sensitivity, overall metabolic health, as well as your average rate of ageing as we’ve seen in a previous post on insulin and the genetics of longevity.

Second, when you get the results back, you will be able to tell from your triglycerides concentration, in light of your insulin level, either how well the body is using fat for fuel—in the case you are already lean, or how fast you are burning your fat stores—in the case you still have excess body fat to burn through.

And third, resetting metabolic health can be done at any time and at any age, and is yet another thing that shows us how incredible our body is—the more we learn generally or individually, the more amazing it reveals itself to be.

 

Thank you to all our patrons, and in particular Eric Peters, for their continued support. Become a proud sponsor of healthfully and join our patrons today!

Rejecting the lipid hypothesis with a cholesterol of 278 mg/dl and a smile

When it comes to evaluating how likely you are to have a heart attack, the most accurate diagnostic—the gold standard—is the calcium score. The reason why it’s the most accurate is because it’s calculated from an actual 3D image of the heart and the blood vessels around it. A computerised tomography (CT) scan is done, and from it the amount of plaque buildup in all the places where it appears because of the high density of the calcium it contains is measured and summed to give the total calcium score.

3d_image_of_my_heart

3D volume rendering of my heart seen from the top.

Even though it has been estimated that approximately half of heart attacks are caused by non-calcified lesions, this is the closest thing we have to a direct measurement of the amount of plaque in the network of arteries around the heart. From doing this to thousands of people, we know that plaque usually begins to accumulate after the age of 35. Why isn’t the calcium score test done systematically on everyone above 40 in order to assess their immediate risk, but also to track their individual cardiovascular evolution, showing, with a reliable reference each year, how quickly or slowly arterial plaque is growing? Because it’s too expensive. Therefore, it’s only prescribed to people who are deemed to be at high risk based on other so-called “risk factors”. You know the list: overweight, sedentary, smoking, stressed, etc. But the clincher in this list of risk factors, the one factor that has pretty much eclipsed all the other ones, at least for the past few decades, is high cholesterol.

The focus on cholesterol was, over time, shifted to LDL, the “bad” cholesterol, and later on the ratio between it and HDL, the “good” cholesterol, terms introduced by the pharmaceutical industry to convince us that there is a battle between a good guy and a villain that must be stopped, which they can help with by providing us cholesterol lowering statins, even if with each passing year, the evidence exonerating cholesterol and lipoproteins from any wrong-doing in the genesis and progression of cardiovascular disease has been accumulating. Still, for people and for doctors, it’s really hard to overcome the several decades of conditioning we’ve suffered holding cholesterol as the main culprit for heart disease.

Fortunately, this knowledge and information have been shared and available for as long as the first experiments that set us on this damning direction in thinking and mindset. For my part, I first read a clear expose on the function of cholesterol and lipoproteins from Ron Rosedale over 10 years ago. Then I read it from Uffe Ravnskov, then from Anthony Colpo, then from Malcolm Kendrick who has and to this day continues to investigate the topic and share his findings on his blog, and then from Gary Taubes. All of this has taught me that cholesterol, HDL, and LDL, are not only not dangerous, but that they are essential and crucial for optimal health. This, I shared with you in But what about cholesterol? and shaped my diet to maintain healthy levels: I restricted carbohydrates and polyunsaturated oils, and have gotten most of my calories from minimally processed saturated fats from grass fed animals fats, coconut oil, butter, and olive oil. In this endeavour to maintain strong cholesterol and lipoprotein levels, as you can see below, I have succeeded.

The following plot shows all the measurements of total cholesterol I have ever gotten made from blood tests over the past decade. What you can see is that in late 2007—a time before which I ate mostly complex carbohydrates and polyunsaturated seed oils while avoiding animal and saturated fats—my total cholesterol was below 150 mg/dl. Since then, it has been generally around or above 200 mg/dl with a slight upward trend over the years.

ts_total

My own total cholesterol levels in mg/dl measured from late 2007 to mid 2018.

If we look at the concentration of low and high density lipoproteins LDL and HDL, we also see consistently high levels, with LDL typically 10-30 mg/dl higher than HDL levels. Unsurprisingly, the same general shape and trend are is seen in these measurements as are seen in those of the total cholesterol.

ts_hdl_ldl

My own LDL and HDL levels in mg/dl measured from late 2007 to mid 2018.

Many of you have been reading this blog for a while, and I trust that you have therefore also known for a while that cholesterol is good for you, and that we should strive to have robust levels of HDL, LDL, and total cholesterol. Whether you have managed to overcome the conditioning we have all been subject to over our lifetimes about the purported but never-substantiated dangers of cholesterol and saturated fats, I cannot know. But I hope that I have at least helped a little in that respect.

In any case, I have for several years, every since I first read about the calcium score, wanted to get this test done, and see where I actually stood on the arterial calcification scale. I’ve never had fears or apprehension about it because even when I first read about it, I felt that I had a pretty good idea of the process by which cardiovascular disease evolved, and was following a regime that I knew would minimise the likelihood of atherosclerosis. But still, there is a big difference between having confidence that something is the case, and actually knowing that it is by seeing observational, quantitative, measured evidence for it. Finally, this spring, I was able to get a calcium score done.

I was very lucky to be referred to a young (45), well-informed, and open-minded cardiologist who also does research and has led trials on a group of several thousands of people who work at the Santander Bank campus near Madrid. He also happens to be the head of the cardiology imaging unit of the Clinical Hospital San Carlos in Madrid, a post he has held for more than 6 years now. So, he’s not just any cardiologist: he’s one of the best, and most importantly, one of the very best in cardiology imaging, which was exactly the purpose of consulting with him in the first place. I could not have been in better hands.

On our first appointment, after the initial conversation and questions regarding medical and health history, his assistant helped do an ECG, which looked “perfectly normal”, he said. Then he did the ultrasound with Doppler imaging that allows to see the heart pumping and the blood flowing with a colour coding of red and blue for the blood flowing away and towards the probe. To the trained eye of the imaging cardiologist, the Doppler ultrasound shows how the heart moves, how the cross-sections of the arteries pulsate with the heart beats, how the valves open and close, how flexible the tissues are, and how impeded or unimpeded the flow is. After a thorough examination, from one side and then from the other, he said everything looked very good.

At the end of the appointment he wrote a prescription for the CT scan to be able to get my calcium score, and another for a set of blood tests to which he willingly allowed me to request any additional one I wanted to have done. Before leaving the clinic, the assistant was able to arrange to have the blood test and the scan on the same day one week later: the blood test would be done in house first thing in the morning, and the scan would be done afterwards at the best medical imaging facility in the city.

The day before the scan, I read up on the test, how it’s done, how the measurements are made, and what the score means. I found out that, first, that the measuring of the amount of plaque buildup was done by eye, meaning that the experience and know-how of the cardiologist doing it was quite important. Second, I found out that the scale was not normalised like a scale from 1 to 10 or 0 to 100; that it was from 0 to whatever, which could be 400, 1000 or 4000. Although I was surprised and a little disappointed at first—we all love to get a score that can be immediately compared to everyone else’s, and gives us a sense of where we stand with respect to the rest of the population—I quickly realised that this made good sense given that it is not a relative but instead an absolute measure of plaque buildup in the arteries: naturally, this can go from no plaque to a little bit, to a lot, and to a ton of plaque. One could imagine estimating a maximum amount—say the amount needed to completely fill up the arteries—and use that as the normalising factor representative of 100%, and expressing every other result with respect to this. For now, this hasn’t been done, and the guidelines for interpreting your calcium score suggest values as follows:

  • 0 — No identifiable plaque. Risk: Very low, generally less than 5 percent.
  • 1 – 10 — Minimal identifiable plaque. Risk: Very unlikely, less than 10 percent.
  • 11 – 100 — Definite, at least mild atherosclerotic plaque. Risk: Mild or minimal coronary narrowing likely.
  • 101 – 400 — Definite, at least moderate atherosclerotic plaque. Risk: Mild coronary artery disease highly likely, significant narrowings possible.
  • 401 or Higher — Extensive atherosclerotic plaque. Risk: High likelihood of at least one significant coronary narrowing.

I got the blood test results back before the calcium score: everything looked good. Because most of my blood markers have been stable for years, especially the metabolic markers related to glucose and fat metabolism, the ones I am most interested in are those I need to monitor: things like B12, folate, homocysteine, and D, all of which need to be controlled and their levels adjusted with supplements; those that show my hormonal status, especially for the thyroid and sex hormones; and finally the markers of systemic inflammation which should always be as low as possible. The cholesterol panel is the one that for me has the least importance. But we are here considering cholesterol and lipoproteins in relation to cardiovascular risk assessed by means of the calcium score. So, these were the measured values: total cholesterol was 278 mg/dl, HDL was 122 mg/dl, LDL was 145 mg/dl, VLDL was 11 mg/dl (ref: <40), lipoprotein(a) was 4.40 mg/dl (ref: <30), and the ratios of total/HDL and LDL/HDL labelled atherogenesis indices were 2.28 (ref: <4.5) and 1.19 (ref: <3.55), values which are all deemed very good, of course.

A few days later I got my calcium score back. What do you think it was? You know I’m currently 45 and that calcification begins to grow after the age of 30-35, and has definitely progressed by the age of 40. You also know that—from what we are told by most doctors and health authorities—that plaque buildup and calcification is an inevitable part of ageing, that no matter what we do or eat or not eat, even if we might be able do things to slow it down, plaque accumulates and calcification progresses in only one direction: upward and onward. With this in mind, what would you guess my calcium score was?

My calcium score—based on 3D imaging of the heart and the region around it, and calculated by the one of best imaging cardiologist in Spain—was 0. It wasn’t 10 or 20. It wasn’t even 1, or 2, or 3. It was zero.

In our scientific training we learn that theories can never be proven—that they can only be disproven, and that hypotheses can never of accepted—that they can only be rejected. We also learn that to disprove or reject a theory or hypothesis, what is needed is a single contradicting piece of evidence, a single contradicting observation. The lipid hypothesis—that elevated blood cholesterol leads to atherosclerosis of the arteries, and that therefore decreasing blood cholesterol concentration significantly reduces cardiovascular risk—has been ingrained into our psyche more solidly than almost anything else that we collectively believe. But faced with this evidence, even if it is from one person only, of having maintained “elevated” fasting cholesterol levels consistently for a decade while in spite of this having gotten a perfect calcium score at the age of 45, the hypothesis must surely be rejected.

Even if we didn’t have any other evidence at all, according to the scientific principle that one contradicting piece of evidence is sufficient to reject a hypothesis, this single instance of my history of high total cholesterol together with a calcium score of zero is enough to reject the hypothesis that having elevated blood cholesterol levels over a long time leads to atherosclerosis and therefore to cardiovascular disease.

And we can be sure I’m not the only one. In fact, I’m willing to bet anything that most people in the low carb community who have been low carbers for as long as I have will have high cholesterol levels and low calcium scores. But still, to change the mindset of several generations of doctors, journalists, and people everywhere—hundreds of millions of educated people conditioned from decades of misinformation—will take years, probably decades. That’s how we are as social animals: stubborn in our beliefs.

In any case, I hope you, at least are, if you weren’t already, are now convinced that having high cholesterol does not cause atherosclerosis. Are you now curious to find out what your calcium score is? If you do get it done, please share.

For my part, I feel even more confident than I did. Even if I assured you more than five years ago in the spring of 2013 in At the heart of heart disease that you could be entirely free from cardiovascular disease by following some basic guidelines I listed regarding our eating, drinking, and living habits, there is nothing like observational evidence. And now we have it.

 

Thank you to all our patrons, and in particular Eric Peters, for their continued support. Become a proud sponsor of healthfully and join our patrons today!

Case study: B12 deficiency, rapid weight loss, protein in the urine, osteoarthritis, elevated vitamin D

Just last week, a friend of mine wrote me this:

My mom has not been well.  Not eating well, massive head ache, lost a lot of weight.  Blood test results yesterday showed that she’s B12 deficient;  urine, however, has too much protein.  Any idea why?

I suppose, since he asked me, it most likely meant her MD didn’t offer an explanation for the test results.  One this is sure, neither she nor he knew what to do.  My feeling is that he asked just in case I knew anything that could help. And I did. So, I did.

Let’s go through the analysis together:

case_study_analysis

Is it normal to have protein in the urine?  What is supposed to be excreted in the urine?  What organ regulates what goes and what doesn’t go into the urine?  Under what circumstances would protein end up in the urine?

From a biological standpoint protein is precious.  From an evolutionary standpoint protein is hard to come by and hence relatively rare.  Therefore, the body has evolved to use and keep as much protein as it can.  The urine is intended to excrete uric acid, which is the main acid produced by metabolic processes.  Urine is excreted through the urethra, it is stored in the bladder, and it is produced by the kidneys, which filter the acids out of the blood.  The kidneys try to prevent large molecules like amino acids and glucose from going through into the urine.  The solids in the blood are separated from the water, the acid is filtered out of it, and depending on the state of hydration, more or less water is used to make urine or returned back to the blood.  The only circumstances under which protein would end up in the urine are 1) that the kidneys are not working properly, and unable to filter the protein out of the blood, 2) that there is a serious excess of protein in the blood, or 3) that there is both kidney dysfunction and excess amino acids in the blood.  We’ve explored kidney function in great detail before in The kidney: evolutionary marvel, and this understanding comes from there.

This means we already know that his mom either has kidney disease, that there is too much protein in the blood, or both.  But he wrote that she had lost a lot of weight.  Losing weight can be due to fat loss, muscle loss, or both.  Usually, very rapid weight loss in the elderly is not voluntary, and almost always means rapid loss of fat and muscle.  Therefore, for sure, the protein in the urine was the result of a the fast weight loss with rapid breakdown of muscle tissue.

But why?  Why would she all of a sudden start losing weight so fast?  What could have happened or triggered this?

Well, he also wrote that she was found to be B12 deficient.  And if this was recognized by the conventional MD who ordered the tests, you can be sure B12 levels were very low: surely below 200 pg/ml.

Do we become B12 deficient all of a sudden?  Or do B12 levels decrease slowly and gradually over the years?  Can we even become B12 deficient all of a sudden?  Why do we become B12 deficient in the first place?  And why is B12 important and relevant in this case?

It is possible to become B12 deficient all of a sudden.  This happens when our levels are marginally acceptable to start, and we receive a large dose of an anesthetic, before a surgery, for example.  Anaesthetic drugs deplete B12; and the larger the dose, the more severe the depletion.  But this is certainly not the majority of cases.

Most of the time, B12 levels decrease slowly and gradually over the years,  either from inadequate intake, or from compromised digestion.  In the younger population, it is usually from inadequate intake—as is the case for vegans and vegetarians.  In older adults, it is usually from compromised digestion—as is the case from the middle aged to the elderly, generally from a damaged gut and stomach cells that do not produce enough hydrochloric acid needed to break down the protein we eat.

As some of you will remember, we’ve also explored the importance and functions of vitamin B12 in B12: your life depends on it and more recently in Case Study: Homocysteine, B12, and folate.  Vitamin B12 is most important for its role in the nervous system: for healthy nerves and proper brain function.  But it is also an important anabolic nutrient essential in building and preserving muscle tissue.  Bodybuilders everywhere have been taking B12 supplements for at least 4 decades, exactly because it’s a potent natural anabolic.

Therefore, here is where our analysis leads us:

The most probable explanation is that his mother has been growing more and more deficient over the years, a B12 deficiency developed over several decades that just recently reached critically low levels. This triggered rapid weight loss that caused both the loss of body fat stores and the breakdown of muscle tissue.  The fat loss released streams of toxins that have been accumulating in the fat cells over years and years, and which caused the massive head aches from which she was complaining.  The muscle loss, the rapid breakdown of muscle tissue due to the extreme B12 deficiency, caused the kidneys to be overwhelmed and become unable to keep all these amino acids in circulation, and the protein therefore spilled into the urine.

My recommendation: B12 shots of 1 mg once a week for 10 weeks, and then of 5 mg once a month for the rest of her life.

 

The story doesn’t end here.  It turns out that she has osteoarthritis and she’s in pain.  Some time ago some friends of hers recommended taking vitamin D supplements, and so she did.  When she got her blood test done, her 25-OH-D was through the roof at 127 ng/ml.  If you’ve read our last post on vitamin K2 you will know that this is possibly the worst thing that someone with arthritis can do: high levels of D without correspondingly high levels of K2 will accelerate soft tissue calcification.  And since osteoarthritis is a disease of calcification, it will make everything much worse than it already is.  Naturally, I immediately recommend she stop taking vitamin D and start taking large doses of vitamin K2 as soon as possible, before something more serious like a stroke or a heart attack happens.

He sent me the blood tests, which I examined to get a better picture.  Interestingly, few markers were out of the reference ranges.  This is probably why nobody said anything other than to point out the obvious abnormalities: low B12, high D, and protein in the urine.

But in addition, what could be seen was that both urea and creatinine were near the top of their range, which is expected from rapid weight (muscle) loss, and the eGFR (the estimated glomerular filtration rate) was at the low end of the reference range, which is expected from compromised kidney function given the protein in the urine.  C-reactive protein was high but not super high.  This signals system inflammation, and is naturally excepted for someone with arthritis, as we also have seen together in the past (https://healthfully.net/category/arthritis/).  Lastly, calcium was also high, but nevertheless within the reference range, something we would expected for someone with high D and not enough K2.

 

I asked if she was taking medications, and she was.  Several different drugs among which were a statin drug to lower cholesterol, a malaria drug used to treat symptoms of arthritis, and a couple of high blood pressure drugs one that is a diuretic and forces the kidneys to excrete more water, and the other that is an angiotensin antagonist that blocks the hormone which tells the kidneys to retain water when hydration is inadequate.  I replayed my view that drugs typically always attempt to block some pathway, and prevent the body from doing something that it naturally does to protect itself.  And in this case, she should wean herself off all of these over a few weeks.

I also explained that one of the most serious side effects of statin drugs is that they cause muscle wasting, promoting muscle tissue breakdown.  Statins do this in everyone, but in the elderly who already have accelerated muscle breakdown, it can be very serious.

My final recommendations, beside coming off the various drugs gradually to avoid a shock to the body, were as simple as possible for an old woman to follow: high dose B12 shots, high dose K2 pills, and high dose Mg as L-threonate, plenty of water and salt each day, a low carb diet rich in animal fats and green veggies, and sodium bicarbonate in water first thing in the morning on an empty stomach.  We’ll see what happens.

 

Blood tests can be used very effectively as a window onto the inner environment of the body.  MDs tend to only pay attention to the markers outside the reference range that appear in bold on the print outs.  But the reference range is derived from the blood tests of the whole population, and the population is far from being optimally healthy, that’s for sure.  What we need are not reference ranges derived from a sickly population, but an understanding of how the body works, what its organs and systems are trying to do, and with that understanding, of what our blood markers should be … ideally. What they should be in the best possible case.

That’s what we have to aim for.  And that’s what we have to learn to do, because we certainly can’t rely on your average MD to help us in this.  If you are an MD, and you are reading this, you already know that you are not your average MD, and I’m pretty confident you also know that your patients are lucky to have you.

 

Thank you to all our patrons, and in particular Eric Peters, for their continued support. Become a proud sponsor of healthfully and join our patrons today!

Reversing calcification and the miracle of vitamin K2

Vitamin K2 is the only known substance that can stop and reverse soft tissue calcification.

If you didn’t stop at the end of that sentence to say Wow to yourself, you should keep reading.

Soft tissue calcification is one of the most serious health problems we face as individuals, as modern societies, and, on a global scale, as a species.  Cardiovascular disease—which leads to heart attacks and strokes, and accounts for nearly half of all deaths in industrialised countries—is a disease of soft tissue calcification: the calcification of our arteries.

Arthritis, of which basically everyone past the age of 40 suffers, and increasingly more with time and with age, is a disease of soft tissue calcification.  It is caused by the calcification of the cartilage in the joints:  the joints of the knees, but also of the shoulders; the joints of the hips, but also of the wrists; the joints of the elbows, but also of the feet and the toes; the cartilage between the vertebrae of the neck and the spine all the way down the back, but also of the hands and of the fingers.

Soft tissue calcification also causes kidney stones and kidney disease.  How many people above the age of 60 don’t have kidney problems?  Hardly any.  And how many young men and women in their 20s and 30s already have kidney stones and kidney dysfunction?  More and more every year.

Every one of the processes generally associated with ageing, from heart disease and stroke, to Alzheimer’s and dementia, to arthritis and kidney disease, to stiffness in the joints and muscles, but also to the wrinkling of the skin, is intimately linked to soft tissue calcification.

And now, let me repeat the sentence with which we opened:  Vitamin K2 is the only known substance that can stop and reverse soft tissue calcification.  It is really remarkable.

Maybe you didn’t know about calcification.  And so, maybe you are wondering why it is such a major and widespread problem, why it affects everyone no matter where we are or what we do.  It’s a good question.  But because we know that only vitamin K2 can prevent this from happening, we already have our answer:  soft tissue calcification is a major and widespread problem because our intake of vitamin K2 is inadequate to provide protection from calcification.

Naturally, the next question is why?  Why is our intake of vitamin K2 so inadequate?  If it is such a crucial essential nutrient, we would surely not be here as a species if intake had always been so inadequate.  Looking at things the other way around, if we are so dependent on adequate K2 intake for staying healthy, this must necessarily mean that we evolved having plenty of it in our food supply.  What’s so different now?

To answer this question with some level of detail—meaning with an explanation more extensive than just saying that it’s industrialisation that stripped our food supply of vitamin K2 as it has for all the essential nutrients to a greater or lesser extent—we have to understand what K2 is, how it’s made, and where it’s found in food.

The short answer is that K2 is found in the fat of pastured animals that graze on fresh green grass, and produced from vitamin K1 by certain kinds of bacteria in their gut.

The longer answer is that vitamin K2 is a family of compounds called menaquinones, ranging from MK-4 to MK-13 depending on their molecular structure.  These compounds are derived from the plant analog, the sister compound, vitamin K1, called phylloquinone, and found in chlorophyll-rich plant foods.  Phylloquinone is consumed by the pastured animal, it makes its way into their intestines, and there it is transformed by the bacteria of the animal’s intestinal flora.  The resulting menaquinone is then stored in the fat cells of the animal as well as in the fat of their milk if they are milk-producing.  Consuming these animal fats in which vitamin K2 has been concentrated will provide this precious essential micronutrient.

If the grazing animal does not feed on green grass, they get no vitamin K1.  If they get no vitamin K1, their gut flora is not only compromised and negatively altered with respect to what it should be if they were consuming the grass they have evolved eating, but it produces no vitamin K2.  If their gut flora produces no vitamin K2, their fat and milk will contain no vitamin K2, and neither their offspring nor any person consuming products derived from the animal will get any vitamin K2.  Hence, no grass feeding, no vitamin K2 in the animal’s fat.

international_dairy_week_banner

It is most natural that grass-eating animals should be grazing on fresh green grass in open pastures.  And yet, it is rather rare.  But without green grass, there is no vitamin K1.  And without vitamin K1 there can be no vitamin K2.

Maybe you’ve already thought ahead, and wondered since it is bacteria that produces vitamin K2 from vitamin K1 in the guts of grazing animals, can’t we make vitamin K2 without the need for grass-fed animals to do it for us?  Yes, it is possible.  Fermented vegetables and dairy products like cheese can also contain vitamin K2.  In fact, in the case of cheese, there is a lot more in the finished hard cheese than in the milk used to make it.  The amount varies widely because it depends on the kind of bacteria.  For dairy products, hard cheeses like Gouda have the most, and for plant foods, even if fermented veggies have a little, the Japanese fermented soybean snack natto is the ultimate source of K2.

As we all know, pastured meat and dairy is not easy to come by in our modern world.  It’s actually quite hard to find.  Our supermarkets and food stores are flooded with industrially produced meat and dairy from animals that have never seen a blade of grass—grass-grazing animals living their entire lives indoors, in stalls, fed and fattened exclusively on grains, corn, and soybeans.  This is how we have stripped our food supply of vitamin K2, and this is why is this a modern phenomenon—most of our grand-parents were still eating pastured meats and animal foods.

And if this wasn’t enough of a blow to vitamin K2 status, trans-fats, which are formed when vegetable oils are hydrogenated to be made saturated and stable (for long shelf life), and which most of us consume in great quantities, contain a K2 analog called DHP (dihydrophylloquinone) that displaces the little K2 that might has found its way into our diet.

It is for all these reasons that soft tissue calcification is so widespread.  And you have at this point what you need to know in order to first stop the process by which your soft tissues are getting increasingly calcified, and then, in time, to remove the accumulated calcium from these tissues.  It’s simple: healthy grass-fed animals produce yellow butter, yellow yolks, and yellowish fat;  you need to eat plenty of pastured animal foods, making sure you eat the fat in which vitamin K2 is concentrated, and, to be sure you have enough to reverse the already present calcification, take K2 supplements.  And this might be enough for you.

If it is, you can head to your browser to find and order some K2 supplements (I currently get mine, it’s a 500 mcg per tablet, from Phoenix Nutrition).  Also, we need to know that the two main forms of K2 are MK-4 (with four double bonds) and MK-7 (with seven).  The first is the one generally found in animal fats that haven’t been fermented, while the second is the product of bacterial fermentation.  Hence, meat and butter contain mostly MK-4, whereas natto, sauerkraut, and cheese contain mostly MK-7.

There is an important difference between these two forms of K2 in terms of their effects inside the body which has to do with their half-life, not in the sense of radioactivity, but in the sense of duration of biological activity in the body.  MK-4 will be in circulation at therapeutic doses for a number of hours, while MK-7 remains in circulation between 24 and 48 hours.  Therefore, to be safe, we need to eat grass fed meat and butter, and take MK-7 supplements (I take 1000 mcg), always after a meal with plenty of fat to maximize absorption.

If you are curious to find out more, if you want to know how menaquinone does this, how vitamin K2 does its miracles inside the body, then we need to take a closer look at the biochemistry of calcium metabolism.

There are three proteins found in bone matrix that undergo gamma-carboxylation via Vitamin K-dependent enzymes: matrix-gla-protein (MGP) (Price et al., 1983), osteocalcin (bone gla-protein, BGP) (Price et al., 1976), both of which are made by bone cells, and protein S (made primarily in the liver but also made by osteogenic cells) (Maillard et al., 1992) (Table V).  The presence of di-carboxylic glutamyl (gla) residues confers calcium-binding properties to these proteins.

MGP is found in many connective tissues and is highly expressed in cartilage.  It appears that the physiological role of MGP is to act as an inhibitor of mineral deposition.  MGP-deficient mice develop calcification in extraskeletal sites such as in the aorta (Luo et al., 1997).  Interestingly, the vascular calcification proceeds via transition of vascular smooth muscle cells into chondrocytes, which subsequently hypertrophy (El-Maadawy et al., 2003).  In humans, mutations in MGP have been also been associated with excessive cartilage calcification (Keutel syndrome, OMIM 245150).

Whereas MGP is broadly expressed, osteocalcin is somewhat bone specific, although messenger RNA (mRNA) has been found in platelets and megakaryocytes (Thiede et al., 1994).  Osteocalcin-deficient mice are reported to have increased bone mineral density compared with normal (Ducy et al., 1996).  In human bone, it is concentrated in osteocytes, and its release may be a signal in the bone-turnover cascade (Kasai et al., 1994).  Osteocalcin measurements in serum have proved valuable as a marker of bone turnover in metabolic disease states.  Interestingly, it has been recently suggested that osteocalcin also acts as a hormone that influences energy metabolism by regulating insulin secretion, beta-cell proliferation, and serum triglyceride (Lee et al., 2007).

These are the first three paragraphs of the chapter Noncollagenous Bone Matrix Proteins in Principles of Bone Biology (3rd ed.) which I found it on the web when I was searching for more info on the biochemical action of menaquinone.

And now, here is my simple explanation of how things work:

The players are the fat-soluble vitamins A, D, and K2;  three special proteins called osteocalcin, matrix gla protein, and protein S;  and an enzyme called vitamin K-dependent carboxylase.

First, vitamin D makes calcium available by allowing its absorption from the intestines into the bloodstream.  This is vital for life and health.  You know that severe vitamin D deficiency is extremely dangerous and develops into the disease that deforms bones called rickets.  Milder forms of vitamin D deficiency are much harder to detect without a blood test, but can and do lead to a huge spectrum of disorders and health problems.  However, without vitamin K2, ample or even just adequate levels of vitamin D will inevitably lead to increased soft tissue calcification.

Vitamins A and D make bone-building cells (osteoblasts) and teeth-building cells (odontoblasts) produce osteocalcin (also known as bone gla protein or BGP) and matrix gla protein (or MGP).  This is key because it is these proteins that will transport the calcium.

Vitamin K2, through the action of the vitamin K-dependent carboxylase enzyme, activates bone and matrix gla proteins by changing their molecular structure which then allows them to bind and transport calcium.

Once activated, bone gla protein brings calcium (and other minerals) into the bones;  and matrix gla protein takes calcium out of the soft tissues like smooth muscle cells of arteries, but also organs, cartilage, skeletal muscles, and skin.  Without this K2-dependent activation, BGP and MGP remain inactive, and the calcium accumulates in soft tissues all over the body.

What completes the act, is that vitamin K2 activates protein S which oversees and helps the immune system clear out the stuff of arterial plaques that remains once the calcium making the plaques structurally stable has been taken out.  And, amazingly, protein S does this without triggering a large inflammatory response.

Even though it is quite straight forward when explained in this way, this understanding of vitamin K2 and its action in the body is really quite recent: in the last 20 years or so.  For one thing, it was only 10 years ago that Chris Masterjohn solved the 60-year old mystery of Weston A. Price’s X-Factor, correctly identifying it for the first time as vitamin K2. (You can read that for yourself here.)  And although some laboratory studies and experiments on vitamin K were done several decades ago, the majority are from the last 10 years (take a look at the references in Masterjohn’s paper.)

We’ll stop here for now.  But we’ll come back to vitamin K2 because there are so many other amazing things it does for our health.

This article was inspired by Dr. Kate Rheaume-Bleue’s book entitled Vitamin K2 and the Calcium Paradox.

Thank you to all our patrons, and in particular Eric Peters, for their continued support. Become a proud sponsor of healthfully and join our patrons today!

Ten years of carbohydrate restriction: here’s why

It was almost exactly ten years ago, in March 2008, that I read Ron Rosedale’s Insulin and Its Metabolic Effects.  I now know that this is surely the one thing I’ve read that has had the most impact on my life. Rosedale’s presentation was a total revelation to me:  I had never read anything about insulin before, and his explanations of the biochemical and physiological functions and effects of insulin on the body all made perfect sense in and of themselves, but also appealed to my appreciation and reliance on complete explanations that are consistent with the facts we can observe about them.  I eliminated insulin-stimulating carbohydrates from my diet overnight.  That was that.

We were then still vegetarian at home.  Hence, the family breakfast, following Mercola’s example, became smoothies made of raw, local, pastured eggs with berries and stevia.  That lasted quite a while.  I always travelled with my hand blender and stevia, brought eggs if it was for short trip, or scouted out places to get good ones when the trip was longer.  Throughout a summer trip along the American west coast, I made our raw egg smoothies every day, in hotel rooms and campgrounds.

At one point, I discovered coconut oil and coconut milk.  The breakfast smoothies evolved to being made of eggs and coconut milk with berries, and eventually only coconut milk, berries and stevia.  This period lasted several years until we moved on to cold pressed green juice with coconut milk; it was two thirds juice and one third milk.  We also did this for several years until about two years ago when our son left for university, at which point we dropped having breakfast entirely to allow for a daily overnight fasting period of about 16 hours from after dinner to lunchtime.

Food intolerance testing in 2014 showed that all three of us were intolerant to eggs; we removed them from our diet.  My wife and I had the most and our son the least intolerances; this was not surprising given we were a lot older than him.  It also showed my wife and I were intolerant to most dairy products; we removed them from our diet.  We were also intolerant to grains: both highly intolerant to wheat, and then I, in addition, somewhat less so to barley, malt, and quinoa—we ate quinoa almost daily for years as our son was growing up.  He, although not intolerant to dairy or wheat, was intolerant to almonds, pistachios, and brazil nuts. (Here are my test results, if you’re interested.)

Imagine: vegetarian for 20 years, with a diet during these two decades from teenage hood to middle adult hood consisting primarily of wheat and grain products, beans, cheese and yogurt, eggs and nuts.  Of course, also plenty of sweet fruit, starchy vegetables, and salads, as with is true for most vegetarians.  But the bulk, both in volume and in calories, was from grain products, cheese, and eggs.  The shocker for me was that the food intolerance test painted the profile of a meat-eater:  if you remove grains, dairy, and eggs, what is left is animal flesh, vegetables and fruits.

If now, in addition, you remove (most) fruit and starchy vegetables (most of the time) to avoid insulin-stimulating carbohydrates, all that is left is animal flesh and green vegetables.  That’s just how it is.  We also used to eat almonds—the richest in magnesium, and brazil nuts—the richest in selenium, almost daily.  But because our son was intolerant to both and I was intolerant to brazil nuts, we removed those from our diet as well.

IMG_2275

These were all food intolerances; they were not allergies.  But they were nonetheless intolerances, some stronger, some weaker.  If you are concerned about health in the sense of being in the best state of health you can, then obviously you must not eat foods to which you are intolerant.  Otherwise, your immune system is triggered each time the offending molecules in those foods enter the gut and bloodstream.  This gradually but inevitably makes the intolerance greater, your system weaker, and body sicker.

Over these ten years, I’ve read quite a few books, articles, blog posts, and detailed discussions about health-related matters.  I’ve also experimented quite a bit with my own diet, and learned a great deal from that.  The other thing I’ve done a lot of, is have conversations with people about diet, nutrition, diseases, and the metabolic effects of different foods and of insulin.

My position—which has only grown stronger with time—is that the first and most fundamental pillar of optimal health is having a metabolism that runs on fat.  And this means keeping insulin levels low by restricting sugars and starches.  Not necessarily always, but most of the time, as in almost always.

The first question that people ask when they find out is why: Why do you not eat bread? Bread has forever been essential to humans.  I simply couldn’t live without bread.  Or, why don’t you eat potatoes, or rice, or pasta?  They’re so good!  I simply couldn’t live without potatoes and pasta.  And, you don’t even eat fruit? But isn’t fruit full of vitamins and minerals?

The way I have answered has depended on a lot of things: the setting, the atmosphere, the company, the time available, but most importantly on the person.  Some people are actually interested to find out, and maybe even learn something.  Most, however, are not.  Consequently, I have made the answer shorter and shorter over the years.  Now, I even sometimes say: well, just because, and smile.

Maybe you have wondered, or even still wonder why.  Maybe although you’ve read so many times in my writings that I think everyone seeking to improve their health should restrict insulin-stimulating carbohydrates, you still wonder what the main reason is, what the most fundamental reason for which I don’t eat sugars and starches.  Here’s why:

It’s not primarily because carbs and insulin make us fat by promoting storage and preventing the release of energy from the ever larger reserves of fat in our body: I am lean and always have been.

It’s not primarily because carbs and insulin lead to insulin resistance, metabolic syndrome, and diabetes; inflammation, dyslipidemia, water retention, and high blood pressure; kidney dysfunction, pancreatic dysfunction, and liver dysfunction: my fasting glucose, insulin, and triglycerides have been around 85 mg, 3 milli units, and 40 mg per dl for years; my blood pressure is 110/70 mg Hg, glomerular filtration rate is high, and all pancreatic and liver markers are optimal.

It’s not primarily because carbs and insulin promote cancer growth since cancer cells fuel their activity and rapid reproduction by developing some 10 times the number of insulin receptors as normal cells to capture all the glucose they can, fermenting it without oxygen to produce a little energy and tons of lactic acid, further acidifying the anaerobic environment in which they thrive.  My insulin levels are always low, and my metabolism has been running on fat in a highly oxygenated alkaline environment for a decade.

It’s not primarily because carbs and insulin promote atherosclerosis, heart disease and stroke by triggering hundreds of inflammatory pathways that compound into chronic inflammation and damage to the blood vessels, which then leads to plaque formation and accumulation, restriction of blood flow, and eventually to heart attack and stroke: my sedimentation rate, interleukin-6, C-reactive protein, and Apolipoprotein-A are all very low.

It’s not primarily because carbs and insulin promote the deterioration of the brain, dementia, and Alzheimer’s, both through the damage to blood vessels around and in the brain itself, and insulin resistance of brain cells, which together lead to restricted blood flow, energy and nutrient deficiency, and accumulation of damaging reactive oxygen species and toxins in the cells, and, unsurprisingly, eventually to dysfunction that just grows in time: because my metabolism runs on fat, this means that my brain runs on ketones, and is therefore free of excessive insulin or glucose exposure.

It isn’t primarily for any of these reasons, which, I believe, are each sufficient to motivate avoiding sugars and starches in order to keep tissue exposure to glucose and insulin as low as possible.

My main reason is that, at the cellular level, in its action on the nucleus and on gene expression, insulin is the primary regulator of the rate of ageing.

Insulin is essential for life: without insulin, cells starve and die. It is essential for growth: without insulin cells don’t reproduce, and there can be no growth.  This is why at that most fundamental level, insulin regulate growth in immature individuals.  But in mature individuals, once we have stopped growing, insulin is the primary regulator of the rate of ageing, both in terms of its effect in suppressing the production of antioxidants and cleansing and repair mechanisms within the cell, but also in stimulating cellular reproduction. And the more reproduction cycles, the greater accumulation of DNA transcription defects, the faster the shortening of telomeres, and the faster the ageing.

This is a fundamental fact that appears to be true for all living organisms.  It is as true for yeasts and worms, as it is for mice and rats, as it is for dogs and humans.  And the rate of ageing is the rate of degeneration, of growing dysfunction, of more damage and less repair, of lower metabolic efficiency and less energy, of increased cell death and senescence.  I personally wish to be as healthy, energetic, strong, and sharp as possible for as long as possible.  This is why I personally avoid sugars and starches.  This is why I personally restrict insulin-stimulating carbohydrates.

 

Become a proud sponsor of healthfully! Join our patrons today!

How much water do you lose during a bath?

Have you ever wondered how much water you sweat out during a bath? Well, I often did. A few years ago, I had a very regular schedule in the morning because my wife and son had to leave early to make it to school in time.  I got up early to make the green juice for the three of us, but after they left at 7:30, I had plenty of time before going to work.

For a couple months during the winter, I had a bath twice a week.  They were therapeutic baths: I was correcting a long-standing whole body magnesium deficiency from decades of intense physical exercise without ever supplementing with Mg, or anything else for that matter.  I was curious to know, and so I tried to remember to weigh myself before and after each bath, and write that down.  I did it for a while, but I forgot everything about it.

A couple of days ago I did a complete cleanup of my closet, and found the little piece of paper on which I had written all the measurements.  I thought it would be fun to share that with you.

I tried to stick to the same conditions in terms of drinking and peeing, but I wouldn’t call it a tightly constrained scientific experiment. I made 15 measurements of my weight before and after soaking in the bath at about 45-47 C for approximately 45 minutes, and calculated the difference:

  1. 59.6  58.9  0.7
  2. 59.5  58.9  0.6
  3. 59.6  58.8  0.8
  4. 60.3  59.8  0.5
  5. 59.6  58.8  0.8
  6. 60.1  59.5  0.6
  7. 59.6  58.9  0.7
  8. 60.0  59.4  0.6
  9. 60.4  59.6  0.8
  10. 59.4  58.9  0.5
  11. 59.9  59.3  0.6
  12. 60.9  60.3  0.6
  13. 60.6  60.1  0.5
  14. 60.6  60.0  0.6
  15. 60.5  59.9  0.6

This is what the distribution of the differences looks like:

histo-diff

Frequency distribution of difference in body weight before and after bath. (The digital scale had one digit, and assuming the precision on each measurement is half that (0.05 kg), this would make the combined uncertainty on each calculated difference the square root of twice the square of that, and hence 0.07 kg.)

Given that there are various trends in our weight from day to day that depend on a wide range of factors, only the difference between the weight before and after the baths is important for us here. But because they all have the same uncertainty, it has no effect on the mean, which turns out to be 0.63 (9.5/15); the variance, which turns out to 0.01; and the error on the mean, which turns out to be 0.03. Hence the mean difference in weight before and after is 0.63 +/- 0.03 kg.

There would have certainly been variations in the temperature of the water, which could account for the variations in the before and after differences ranging between 0.5 and 0.8 kg. We could say that the hottest baths resulted in a water loss of 800 ml, whereas the more moderate temperatures caused a loss of 500 ml. In any case, as we said, the average of the 15 measurements is 0.63 kg, and this equates to 0.63 litres or 630 ml of water.

I think it is reasonable to consider this is in terms of the fraction of water loss with respect to body weight, which for me at the time would have been equivalent to about 1% of body weight. This is probably not precisely the case, but a good guideline to follow: if you weighed 80 kg, you should consider that a 45 minute bath would cause you to lose about 800 ml of water; if you were 100 kg it would cause you to sweat out a full litre.

And so, that’s it. The answer to the question of how much water we lose during a bath—or actually more specifically, during a bath in which the water is around 45 C, and in which we soak for 45 minutes, and in which we have dissolved 1 cup of baking soda and 1 cup of magnesium chloride—is about 1% of our body weight.  Very easy to remember.

Therefore, ideally, we would be sipping cool alkaline water throughout the bath to make up for that loss and minimize the dehydrating effects of that much sweating.

Have you ever done this on your own: weighed yourself before and after a bath to see how much water you lost? If you have, I’d be very curious to know what you found. If you haven’t but are intrigued, and want to do it, please go ahead and let us know.

Join our patrons today!

Case Study: Homocysteine, B12, and folate

Homocysteine is an amino acid that occurs in the body as an intermediate in the metabolism of methionine and cysteine. Folic acid is a vitamin of the B complex, found especially in leafy green vegetables, liver and kidney. (Both these definitions are from the New Oxford American Dictionary on my MacBook.) Folic acid is B9, and folate is a salt of folic acid, but the two names are used interchangeably.

Homocysteine is normally broken down and recycled so that it doesn’t accumulate. This relies on sufficient amounts of vitamins B12, B6 and B9 being available to facilitate this process. Homocysteine, abbreviated Hcy, is a highly inflammatory substance associated with much higher risks of cardiovascular events. Research (AHJ 2004) has shown that it “causes endothelial dysfunction and damage, accelerates thrombin formation, inhibits native thrombolysis, promotes lipid peroxidation through free radical formation and induces vascular smooth muscle proliferation and monocyte chemotaxis.” 

Naturally, we should strive to keep Hcy levels in our blood as low as naturally possible, which means around 6 micromol per litre. The higher its concentration, the worse off you are in terms of the potential for damage to the arteries and cardiovascular events. For a detailed look at Hcy in relation to vascular disease, read this article by Dr Neville Wilson (thanks Ivor Cummins).

Last week I explained something about Hcy, B12, and folate to my son who was getting ready to go back to university for his second year at St-Andrews. Afterwards, I thought it would be useful to share this with you, and I started working on this post.

This story is drawn from my own personal history. It is a case study with me as the primary subject using data I have collected from regular blood tests over these last seven years. However, I also use data from both my mother’s and my son’s blood test results that happen to be critical for understanding my own blood test results. Below, I describe the whole story and analysis of the data in detail. If you are not interested in the details, the punchline is this:

If your homocysteine levels are high, you should supplement with B12 and active folate in order to ensure the body has what it needs to process it. Some people lack the enzyme needed to activate the folic acid we get from food. This prevents the body from breaking down homocysteine that consequently accumulates in the blood.  This is a genetically transmitted trait, which I think I have inherited and transmitted to my son. Because of it, we must supplement with activated folate to ensure breakdown of Hcy.

The first time I read about Hcy was many years in Anthony Colpo’s book The Great Cholesterol ConThe subject was discussed towards the end of the book in a short chapter, but I was left with a strong impression. Colpo emphasized that Hcy—unlike cholesterol—was a good predictor for heart disease. And it wasn’t just good: it was one of the best. But this wasn’t the only reason it made such an impression on me.

I read Colpo’s book after reading Uffe Ranvnskov’s Fat and Cholesterol are Good for You, and Malcom Kendrik’s The Great Cholesterol Con, both of which were about fat, cholesterol and heart disease, but neither of which discussed homocysteine. Then I read Gary Taubes’s Good Calories, Bad Calories, and again, Hcy wasn’t given the share of attention it seemed to deserve based on Colpo’s comments. If you’re new here, or if you need a refresher, you should read But what about cholesterol? and At the heart of heart disease.

The first time I got my Hcy levels checked was on August 27 in 2012. The result was 18.3 micromol per litre. On the results, the reference range was 5 to 15; moderately elevated was 15 to 30; and elevated was indicated as anything greater than 30 micromol per litre. Beside the middle range, it was written vitamin deficiency in parentheses. But it wasn’t written what vitamin deficiency would cause elevated Hcy. The doctor from whom I had requested the test didn’t know either. (As you might have experienced for yourself, most MDs don’t really know much when it comes to blood test results.)

I had already started supplementing with B12 by that time. Most of us, as vegetarians, quickly and usually angrily dismiss nutritional advice or warnings of potential problems from deficiencies that non-vegetarians love to offer when they find out we don’t eat meat. We usually interpret these as justifications of their feelings of guilt for not being vegetarians themselves. At least I know I did when I was vegetarian. Although most people who do give their unsolicited advice are rarely knowledgeable in the subject matter, I now know that I was dead wrong about my quick dismissal of several things in relation to dangerous deficiencies that come about when we eliminate meat and animal products from our diet. Vitamin B12 is surely the best example.

It was after reading this article on B12 by Mercola that I came to realize how disastrous were the consequences of living with low levels of B12, and in my case, how disastrous were the consequences of having been vegetarian for 20 years. I started supplementing right away, and got my first B12 blood test a few months later in 2010 on September 8. The result was 271 pg/ml. According to the lab who did the test, this was within range. But I knew it wasn’t. I knew this was much too low, and that I desperately needed to correct this as fast as possible, stop and hopefully reverse the neurological degradation associated with my long-standing B12 deficiency.

In that article was also underlined the connection between low B12 and high Hcy levels. It read: Cardiovascular and cerebrovascular diseases have a common risk factor – increased homocysteine levels in blood. Studies show insufficient amounts of folic acid and vitamin B12 can elevate your homocysteine levels, potentially increasing your risk for heart disease and stroke. So, of course I was worried. I was also angry at myself for having been so stupid and stubborn all these years… these 20 long years. But at least I now knew what I had to do: I needed to boost B12 levels and keep them high.

And I did. Look at how my B12 levels evolved over 7 years:

ts_b12

Blood B12 levels measured over seven years since September 2010.

Does seeing this make you wonder how the Hcy levels evolved? My expectation was that Hcy would drop as B12 rose. With some time delay of course, but still: as B12 levels increased, homocysteine concentration would decrease. Here is what happened:

ts_hcy

Blood homocysteine levels measured over five years since August 2012.

Not so obvious to interpret, right?

Let’s look at all the tests in which both B12 and Hcy were measured, and plot them one against the other. It’s called a correlation plot, and this is what we find:

hcy_vs_b12

Homocysteine plotted against B12. Data point numbe labels show chronological order of tests.

So, there clearly is an inverse relationship between levels of Hcy and B12. There is no doubt in this. But at least for me, it’s not very tight. The correlation coefficient and the uncertainty on it quantify this relationship.

The coefficient can have any value between -1.0 and 1.0: a value of 1.0 signifies perfect correlation; a value of -1.0 signified perfect anti-correlation; and a value of 0 signifies that there is no correlation at all. The uncertainty on the coefficient quantifies how well the coefficient is determined from the data points, and therefore how loosely or tightly they are spread around the overall trend in the data set.

A coefficient of -0.66, as we found, tells us that there is indeed an anti-correlation in the relationship between Hcy and B12 concentrations. The uncertainty of 0.22 tells us that the correlation is not so tight. And when we look at two time series above, we see that although B12  has been above 600 pg/ml since 2014, Hcy levels remained more or less flat until the end of 2016.

My initial interpretation was that because I had been B12 deficient for basically 20 years, correcting that long-standing deficiency, and repairing the damage caused by it to the body and in particular to the nervous system, required maintaining consistently high levels of B12 for a long time, allowing the body the time needed to repair itself: two decades of B12 deficiency could obviously not be corrected in a few months. Maybe it was only after these 7 years of intensive B12 supplementation that the positive results were beginning to manifest themselves in this way.

And by intensive, I mean pretty serious. I started taking oral supplements of 2000 mcg per day; then transitioned to patches which are more effective because the B12 is absorbed directly through the skin without having to go through the digestive system; and finally moved on in early 2015 to monthly intramuscular injections of 5000 mcg of methycobalamin. Nevertheless, Hcy remained pretty much the same, even after months of injections. What was going on? Why wasn’t Hcy dropping?

Maybe you are thinking that there might be another way we could use to check how much influence B12 levels have on Hcy? Well, I have something I think is quite remarkable to share with you.

At the very end of July 2014, I brought my mother to a specialized blood analysis clinic, and ordered the complete set of tests listed on my essential blood test reference sheet. The results came back a few days later: her B12 was at 292 pg/ml; her folic acid was at 11.6 ng/ml; and her Hcy was at 30.5 micromol/l. She was 82 and, just for the record, it was the first time in her life that her B12 and Hcy levels had been measured in a blood test.

I immediately got a friend of hers and ex-nurse to give her methylcobalamin injections a couple of times a week. Five weeks later in early September we repeated the test for homocysteine. The result was 9.5!

My 82 year old mother’s homocysteine levels went from 30.5 to 9.5 micromol/l in 5 weeks following 10 injections of 1 mg doses of methylcobalamin B12.

She was out of the red. At least on that front. Hcy of 9.5 micromol/l is still moderately elevated when we consider that we would ideally have it around 6 or so. But 30.5 was dangerously high. This, to my mind, is strongly indicative of the crucial importance and immediate effect of vitamin B12 on homocysteine metabolism.

It wasn’t a tightly controlled experiment where everything was kept the same except the one variable under investigation, which in this case would have been the B12 injections. It wasn’t, because my mother did also at the same time adopt a new dietary regimen, following an alkalizing, very low carb, low protein, high fat, intermittent fasting cleansing protocol I had designed for her, that also included quite a number of other supplements. All were food supplements: vitamins A-D-K2, niacinamide, co-enzyme Q10 as ubiquinol, phospholipids as sunflower lecithin, omega-3s as krill oil, turmeric extract, tulsi extract, chlorella and spirulina, magnesium, zinc, iodine, etc.

Certainly it is true that everything influences everything else, but there’s no question in my mind that as far as homocysteine was concerned, the most important element in this protocol was the intramuscular injection of methylcobalamin approximately every three days. There is also no question that achieving such a drop in Hcy levels at such an advanced age and in so little time is nothing short of amazing.

The point of my retelling of this was to present direct evidence of the strength of the relationship between B12 levels and Hcy concentration. I think it does. Obviously, you are to draw your own conclusions.

Coming back to my case, in the fall of 2013, I stumbled upon The Complete Blood Test Blueprint in which Joseph Williams, a knowledgeable, experienced, and kind MD, was interviewed by Kevin Gianni, the host of Renegade Health, in a series of interviews that covered a large number of blood tests in great detail. I learned a lot things listening to Dr Williams. Admittedly, I was disappointed by the lipid panel discussion, and in particular by the discussion of cholesterol and lipoproteins. But putting this aside, I was generally very impressed.

Dr Williams talked about B12 deficiency at length, but I was already well versed in the subject by that time. I had recently read the book Could it be B12?, made detailed notes of it, and then posted for you B12: your life depends on it. Dr Williams also talked about Hcy. In that discussion was mention of the fact that in addition to B12 (cobalamin), B6 (pyridoxine) and particularly B9 (folic acid) were also essential for breaking down Hcy. I didn’t really think much of it, simply because my diet was and always had been rich in leafy greens, which naturally ensured a high intake of folic acid.

A few years and several blood tests later, I listened to the interviews again. And this time, something caught my attention in the part on homocysteine that hadn’t the first time: it was mentioned, in passing towards the end of the discussion, that some genetically predisposed people lacked the enzymes needed to activate folic acid; and that these people therefore needed to supplement with the already active form of B9 called tetrahydrofolic acid.

It caught my attention because by that time I had several measurements of Hcy that, even with my continued and even intensified B12 supplementation, were not showing evidence of going down. Remember: I started injections in early 2015. But there was something else that made this comment stand out for me: my son’s recent blood test results.

In July 2016 I brought my son to get a complete blood test that comprised all the markers I usually test for, together with all the major hormones, in order to have a baseline for him in his prime. It is certainly true that we can talk about optimal levels for each of the hormones we know and can test for. But our own personal ideal hormonal profile is unique to us. And the best time to get a baseline is when we are 18 years old: full grown adults at our youngest.

Laurent’s B12 was 578 pg/ml, his folic acid was 23 ng/ml, and his Hcy was 10.9 micromol/l. At 18, having had no major health issues, no accidents or serious diseases, a remarkably healthful fresh, green, organic, low carb, high fat diet of unprocessed whole foods for most of his life, I thought that this slightly elevated Hcy could be due to one of three things: either his body was still B12 deficient and just slowly building up its B12 stores, even though the three of us had all started with supplementation and patches at the same time; he was one of these people Dr Williams had made reference to who lacked the enzyme to activate folate, and therefore couldn’t effectively break down Hcy; or both.

I immediately ordered activated folate for us, and we started taking it in August 2016. If you take a look at the second plot that shows my Hcy levels as a function of time, you can see that it was just around 18 micromol/l at the end of July. And half a year later, towards the end of 2016, it was at the lowest it had ever been. Obviously, I was very happy to see this major improvement in achieving a drop in Hcy, something I had been trying to do for so many years. Therefore, also obviously, I continued taking activated folate. As you can see from the next two data points in 2017, Hcy was measured at 10 and then 8 micromol/l. We haven’t made another blood test to check Laurent’s levels. We’ll do that around Christmas at the end of this year when he comes back for the holidays.

Can we see how strong the relation between folate and Hcy actually is? We can plot the measurements we have one against the other like we did above for B12 and Hcy. What we find is this:

hcy_vs_folate

Homocysteine plotted against folate. Data point number labels show chronological order of tests. Arrows mark upper limits.

The relationship is very clear and linear. But I have to admit that I have cheated your eye a little bit. The measurements of folic acid are capped at 24: any value above that is simply reported as greater than 24. This was the case in tests (4), (8), (9), and (10). I show this with little arrows pointing towards higher values. Because the last three measurements were so close together in time, for the sake of clarity in the plot, I placed them at 25, 26 and 27, inversely proportional to the Hcy level. This is why they appear to follow the line. Otherwise, they would be at on the left edge of the arrows, one on top of the other, aligned with point (4), all at 24 on the x-axis. Note that I also plotted my son’s results (labelled as such), adding a data point at (23, 11).

What can we conclude from this investigation? Well, it isn’t totally clear cut and straight forward. I admit. But let’s review the facts:

For me:

  • I was 38 years old at the time of my first B12 test.
  • My B12 levels were low for 20 years: 270 pg/ml when first tested after few months of supplementation.
  • My Hcy levels were high at 18 micromol/l about two years after starting B12 supplementation.
  • B12 is necessary to break down Hcy.
  • It took me 3 years of oral and patch B12 supplementation to reach 600 pg/ml.
  • In early 2015 I started monthly B12 injections.
  • Only after almost 2 years of injections did my Hcy levels drop below 10 micromol/l.
  • But this precipitous drop in Hcy was concurrent with the start of supplementation with activated folic acid.

For my mother:

  • She was 82 years old at the time of her first B12 test.
  • Her Hcy levels were very high at 30 micromol/l.
  • Her B12 levels were low for who knows how long: 292 pg/ml when first tested.
  • She received approximately 10 injections of 1 mg in five weeks.
  • Her homocysteine levels dropped from 30 to 9.5 micromol/l.

For my son:

  • He was 18 years old at the time of his first B12 test.
  • His homocysteine levels were moderately high at 11 micromol/l.
  • His B12 levels were 578 pg/ml.

In addition to this, we have the plots above that show inverse relationships both between Hcy and B12, and between Hcy and folic acid. From this, there are at least three very clear conclusions we can draw:

  1. Low levels of B12 are associated with high levels of homocysteine,
  2. Higher levels of B12 are associated with lower levels of homocysteine, and
  3. Raising B12 levels leads to a decrease in homocysteine concentration.

At this stage and with the data we currently have, going further is more speculative. But here is what I think:

  1. I am one of these people that lacks the enzymes to activate folic acid.
  2. I might have inherited this trait from my mother, or much more likely from my dad, considering how well she responded to intensive B12 therapy. This was most likely also transmitted to my son.
  3. I was B12 deficient, and correcting this deficiency didn’t lower my Hcy levels.
  4. It was only when I started taking activated folate supplements that Hcy levels dropped quickly and significantly.

The reason I think this comes from two lines of reasoning. The first is that, as I just mentioned, it is only when I started taking activated folate that my Hcy levels dropped below 10 for the first time in seven years since the start of B12 supplementation.

The second is that even though both my mother and I were definitely B12 deficient, both probably for a long time, and that this would necessarily have led to an accumulation of Hcy in the blood that would have been greater in her case than in mine due to her age; my son was only 18 years old, and could not have been B12 deficient, at least not for almost 10 years. Nevertheless his Hcy levels were moderately elevated.

This is what I told him the other day. It took me only 5 minutes to tell him; it has taken me a lot longer to write this post. But I think the details are important if we are to understand things well. And by this I mean know what we understand, and know what we do not understand; know what conclusions we can make, and know what is hypothesis or speculation.

It’s not possible to be sure at this stage. We need more data and more experiments. But it’s not easy to gather such data, just because it takes a long time and strong commitments to be consistent with a supplementation programme over months and often years. If you have similar data and are willing to share, I would be happy to take a look at them.

Data like these trace and reveal so much about what’s happening inside our body, below the skin, far deeper than our eyes can see. But we can only begin to understand these measurements and the processes that drive their evolution by spending the time to look at them in detail. This is what we did here together. I hope you found it interesting.

Do you know what are your blood levels of homocysteine, B12, and folate? If not, you better get that checked out.

Become a proud sponsor of healthfully! Join our patrons today!

Want to lose weight? Here’s what you need to know in under 1000 words

One, you don’t want to lose weight: you want to lose fat. You don’t want to lose muscle or bone because they are very important functionally and metabolically. What you want to lose is fat. So weight loss needs to be reworded as fat loss.

Two, roughly speaking, the body is generally either storing surpluses or using reserves.

Three, the major fuels for the body are glucose and fatty acids.

Four, for the body to use fat reserves, insulin levels must be low. Fat cannot be efficiently utilized as long as insulin is high, because insulin promotes storage.

Five, the thyroid gland regulates metabolism and brain function. It requires adequate amounts of iodine without which it cannot work properly. To ensure healthy metabolic function, iodine supplementation is critical.

That’s what you need to know. If you want more details, I can expand a bit.

Insulin regulates fat storage

Every second that we are alive, trillions of biochemical reactions take place. The energy currency is adenosine triphosphate, ATP. Mitochondria produce ATP primarily using glucose or fatty acids. Fatty acids produces a lot more, but glucose is much easier to use. Both are used but one always dominates. In general, if there is glucose to be used, fatty acids are not much. For fat loss, we want to promote fat burning for ATP production to fuel cellular activity.

High glucose levels from carbohydrate intake trigger insulin secretion. This is necessary to bring the glucose into the cell, and to get rid of it from the bloodstream where it causes damage to the tissues by glycation. Within the cell, glucose can be either fermented without oxygen or oxidised with oxygen. Lower oxygen levels (and very high short term metabolic needs) promote fermentation. Higher oxygen levels (and lower metabolic ATP production rates) favour oxidation. More fermentation leads to greater accumulation of lactic acid, which further decreases oxygen levels. Red blood cells do not have mitochondria and therefore can only produce ATP by fermenting glucose.

Lower glucose leads to lower insulin. This triggers the release of fatty acids and glycogen into the bloodstream. If sustained, low glucose leads to the production in the liver of ketones primarily to fuel the brain whose cells can either use glucose, ketones, or medium chain fatty acids because longer molecules cannot pass the blood-brain barrier.

The higher the glucose, the higher the insulin, and the faster the uptake and storage of nutrients from the bloodstream into cells. The lower the glucose, the lower the insulin, and the faster the stored fat can be released and used.

insulinFatStorageFatRelease

Amount of glucose stored as fat and amount of fat released from fat cells as a function of insulin concentration. Plot taken from https://optimisingnutrition.com

The most metabolically active tissue is muscle. The more muscle we have, the more energy is used, and the faster both glucose and fat are burned to supply fuel to the cells. The more we use our muscles, and the more intensely we use them, the more they grow, and the more efficiently they burn both glucose and fat. Also, the stronger the muscles, the stronger and denser the bones will be. This is very important.

Therefore, as we burn more fat, we burn fat more efficiently. As we use our muscles more intensely, we burn more fat. And as we build more and stronger muscle, we burn even more fat even more efficiently, and make the bones stronger.

Different Carbohydrate Intolerance Levels

These mechanisms are universal in animals, but each animal is different, and each person is different. As far as fat loss is concerned, the individuality of people is related to their predispositions to insulin resistance and carbohydrate tolerance, (or actually, intolerance). Every person is differently intolerant to carbohydrates and differently predisposed to insulin resistance.

This is why in a group eating the same diet, there are people who are thin, people who are chubby, people who are fat, and everything in between. Basically, the greater the predisposition to insulin resistance (and the more sedentary), the lower the tolerance to carbohydrates will be, and the fatter you will tend to get. In contrast, the lower the predisposition to insulin resistance (and the more active), the higher the tolerance to carbohydrates, and the thinner you will tend to be.

This translates into different thresholds in the amount of carbohydrate we can eat without negative metabolic consequences, and consequently, the amount under which we must stay in order to burn fat instead of storing it. As a guideline, if you want to burn primarily fat for your body’s energy needs, this threshold would be around 20–25 grams per day if you are fat; around 30–50 gram per day if you are neither fat nor thin, and could be around 80–100 grams per day if you are very thin.

But no matter what your personal threshold happens to be, it will always be the case that the lower the intake of carbohydrates, the lower the glucose and insulin will be, and the more efficiently your body will burn fat as fuel.

Fat Loss Rate

The amount of fat that is burned is determined by the energy balance. The greater the total amount of energy we use, the greater the total energy needs. Total energy needs will mostly be met by energy from food intake and energy from fat reserves. If food energy intake is high, the need for stored energy will be low. If intake is lower, the need for energy from fat reserves will be higher.

Pushing this to the limit—maximal usage of fat stores—we would provide the protein necessary to maintain muscle and other active tissues and nothing more. In this situation, basically all energy needs would be supplied by stored fat reserves and glycogen when needed. This is greatly enhanced by resistance training.

The amount of protein needed is proportional to muscle mass and muscular activity. As a guideline, you can use 1–1.5 grams per kg of lean mass per day in the case of little physical activity, and 2–3 g/kg/d in the case of high muscular activity levels. Excessive protein is not great, but more is almost always better than less.

Fat burning and protein synthesis can be further optimised by intermittent fasting. Extending the time between feedings allows glucose and insulin to drop lower, which increases the rate of fat burning. And by eating fewer but larger amounts of protein in a meal is better because protein synthesis increases in proportion to the amount consumed.

Thyroid function regulates metabolism. Iodine is used in every cell, but in the thyroid, it is concentrated to more than 100 times the average of other tissues, because iodine is the main structural component of thyroid hormones. Iodine supplementation is critical because most soils are highly depleted. It is water soluble and very safe to supplement with.

Summary

  • High insulin from carbohydrate intake promotes fat storage.
  • Low insulin from restricting carbohydrates promotes fat loss.
  • Individual predispositions determine the threshold of carbohydrate tolerance.
  • Below this threshold fat is used as the main source of cellular fuel.
  • The rate of fat loss depends on balance between energy needs and energy intake.
  • Maximal fat loss rates are achieved by supplying just the protein needed to sustain lean tissues.
  • Iodine supplementation is critical to healthy thyroid, metabolic and brain function.

Join our patrons today!

A simple 10-step arthritis treatment plan

What are the most important things we can do to stop and reverse the degeneration, and alleviate the stiffness and pain of arthritis? You can be sure that no matter how bad things are, there are many things that will help, and they don’t involve pharmaceuticals.

We looked in some detail at how to treat arthritis in Treating Arthritis I and II, and have at least one of our readers, an artist, Catherine Bath, who has been able to alleviate a great deal of her stiffness and pain, and recover a good amount of mobility and ease of movement by following the various recommendations we made there and throughout this blog.

Here, prompted by a request from a good friend who needs it, we present a simple treatment plan with the most important elements, and just the essential details needed to understand why the interventions are useful, and how to put them into practice right away.

what-arthritis-pain-feels-like-722x406

Illustration of painful, inflamed, arthritic joints. (Image taken from Everyday Health)

1. Hydrate and alkalise

This is the most important point of all. Without it nothing will work, really. Every joint works thanks to the cartilage that allows the bones to move within it without rubbing against one another. Arthritis is always characterised by the degradation of this cartilage and the pain associated with the inflammation caused by the bones not moving properly or rubbing inside the joints. Cartilage is water (85% by weight) held together in a matrix made mostly of collagen, and chronic dehydration is the first cause of cartilage breakdown (details in Your Body’s Many Cries for Water).

Metabolic acids (mostly uric acid) can only be excreted efficiently by the kidneys when there is an excess of both water in which to dilute the acid, and salt to help carry it out in the urine. Without excess water, the kidneys will prioritise retaining as much of it as they can. Without excess salt, the uric acid will be recycled instead of being excreted in order to to maintain the concentration gradient in the medulla of the kidney that ensures its ability to reabsorb as much water as possible. Chronic dehydration and avoidance of salt, coupled with the drinking of acidic liquids and eating of acid-forming foods inevitably leads to chronic acidosis.

To maintain the pH of the blood at 7.365 in spite of the continuous flow of acids into it from the muscles and digestive system, two main coping strategies are available: 1) The body’s main acid buffering mechanism using the reserves of alkalising minerals stored in the bones and teeth to counterbalance the acid load. If you don’t quite understand the implication here, this means erosion of the bones and teeth to put into the blood some of the alkalising calcium, phosphate and magnesium as acid-buffering minerals. 2) The crystallisation of the uric acid to pull it out of circulation, but then storing it into tissues, of which the joints, regrettably for arthritis sufferers, seem to be used preferentially, even though all tissues can be used for this to a certain extent.

The strategy is simple: drink alkaline water (either naturally so, or made to be with pH drops) on an empty stomach, and allow at least 30 minutes before eating. Aim for 3 litres per day. One litre before each meal, drank over a period of one to two hours, is a simple rule of thumb and easy schedule to remember. And aim for 2 full teaspoons of unrefined salt with your meals.

2. Magnesium chloride and sodium bicarbonate baths

Magnesium is at the very top of the list of supplements for anyone in any circumstance. We explored and explained why in Why you should start taking magnesium today.

Transdermal magnesium and bicarbonate therapy is the best way to simultaneously replenish magnesium stores in the cells, while alkalising the tissues directly by transdermal absorption of magnesium and sodium bicarbonate. If you have a bath tub, do this once or twice per week, or more if you can or need it. Add two cups of each magnesium chloride and baking soda, and soak for 45 to 60 minutes.

I also recommend that in addition to this—but crucially if you don’t have a bath—you take magnesium supplements. I take a fat-bound magnesium supplement called L-Threonate. Another alternative is the amino acid-bound supplement called magnesium glycinate (using glycine). Both of these form maximise absorption. Take it with meals.

3. Silicic acid, collagen, hyaluronic acid, and proteolytic enzymes

An essential constituent of hair, skin, and cartilage. Absorption is poor and slow. This means you need to take small amounts every day for long periods of time. Every morning, first thing, with your first glass of water. You will need to do this in cycles of three months on, three month off. I take Silicea, a concentrated water-soluble silicic acid gel by the German brand Huebner.

Collagen and hyaluronic acid will help greatly in rebuilding the damaged cartilage. Look for type II collagen for better absorption. Now Foods has good products at good prices. Also, glucosamine, chondroitin, MSM have all been shown to be useful for joints.

Proteolytic enzymes are responsible for breaking down, building, and repairing tissues. They can be amazing in accelerating a healing process, no matter what it is. Therefore, this is an essential supplement to take in treating arthritis.

4. Vitamin D3 and K2

These are the two vitamins that control and regulate the availability and deposition of calcium. Vitamin D3 makes it available, and vitamin K2 directs it to the bones and teeth.  Lots of vitamin D3 without K2 will lead to calcification with calcium being deposited all over the place in the arteries and soft tissues. Lots of K2 without D3 will lead to a depletion of available calcium in the bloodstream because it will be stored away in the bones and teeth. K2 is also used to decalcify soft tissues by pulling out and redirecting the deposited calcium from the tissues to the bones.

Vitamin D deficiency is universal in the west, and so is vitamin K2 deficiency. Arthritis sufferers need large doses of both for extended periods of time (at least a year). I recommend taking a combo supplement containing both in an optimal ratio, and take as many capsules as needed to bring vitamin D intake to 20 000 – 50 000 IU per day with breakfast and lunch. For years I took DaVinci’s ADK combo, which I think is one of the best. Now I take Life Extension’s D and K combo, without vitamin A, because its presence dampens the activity of vitamin D3. However, vitamin A promotes the healing of tissues. You can take both, alternating between the two.

Another of our readers who had his entire adult life an arthritic wrist that caused him pain and trouble whenever he used his hand for anything at all, followed my suggestion of taking 50 000 IU of vitamin D3 per day, together with the appropriate amount of vitamin K2 to match in the D3 intake, for six months. Within the first month, he found incredible improvement, something he had never been able to achieve using all the methods and drugs that had been proposed to him by MDs. After three months, his wrist was completely healed. He continued for the entire 6 months just to be sure, and now, his painful, debilitating, arthritic wrist that he was living with for more than 20 years, is a thing of past, a bad memory.

5. Vitamin C

Whole food vitamin C is essential for healing and keeping tissues and cells healthy. And there is definitely a difference between whole food C and ascorbic acid. We discussed this in Vitamin C is not vitamin C. This is not specific to arthritis, but everyone with arthritis should be loading up on it. I take The Synergy Company’s Pure Radiance C. You should take at least three capsules, but better 6 capsules per day, split evenly with each meal.

6. Turmeric extract

Turmeric is one of if not the most powerful natural anti-inflammatory. And inflammation is a hallmark of arthritis. You should take an extract that concentrates the curcuminoids, but you should also think of making yourself hot turmeric drinks, adding as much turmeric to your soups and curries as the flavours and combinations of foods will allow. It always needs to be taken with a lot of fat to maximise assimilation.

7. Food

Naturally, you will have guessed that my recommendations for food are the same as always, but even more important in this case when we are trying to bring inflammation as low as possible, and maximise healing:

  • no simple or starchy carbs because they cause inflammation, tissue damage, and metabolic disorder, except for berries once in a while;
  • unlimited unprocessed saturated fats from coconut oil, butter, and animal sources;
  • enough high quality protein from healthy animals including organ meats, especially liver; and
  • as many green veggies as you like, especially leafy like spinach, kale and lettuces, watery like cucumbers, fibrous like celery and broccoli.
  • Avocados are fantastic to eat as often as you want. Walnuts and hazelnuts are excellent health-promoting nuts (either roasted, or raw and soaked, subsequently dehydrated or not).

8. Sunshine, fresh Air, exercise and sauna

Go out in the sun, go for long hike, expose your skin, breath deeply, run up the hills, work your muscles at the gym if you can, go to Pilates and yoga classes, do lots of stretching whenever you can, and go to the sauna when you can. Make sure you stay 15 minutes to get really hot and for the heat to penetrate into the tissues and joints.

9. Iodine

Iodine is the universal medicine. Everyone needs it, and everyone should be supplementing with it. You can read for yourself why in Orthoiodosupplementation. Start at 12.5 mg and work your way up to 50 mg per day. Increment by 12.5 mg each week. Take the supplements on weekdays and give the kidneys a break on weekends. I take Iodoral, and recommend that. Using the generic Lugol’s solution is as good but less convenient.

10. Melatonin and good sleep

Good sleep is absolutely essential for repair and healing. Make sure you get plenty every day. Melatonin has, in addition to its effects in helping you sleep, many other amazingly health-promoting effects that we will explore in another article sometime soon, I hope.

Last words

Are there more supplements you can take? Of course there are. I personally take all of the above and several others. I wanted to stick to the things which I believe most essential. If I were to recommend additional supplements, I would say to take

  • omega-3’s, which are useful for lowering inflammation, as well as tissue healing and repair. I take Life Extension’s Mega EPA/DHA. Don’t take more than the recommended dose. Omega-3’s are very easily oxidised, and should always be taken in very small quantities.
  • Niacin in the form of niacinamide is also a universally useful supplement because it provides molecular building blocks needed by every single cell to produce energy. I take 500-1000 mg/day, but you could take 3000 mg (1000 mg with each meal). Niacin supplements will also do wonders for your mood (see No more bipolar disorder?).
  • Ubiquinol, the active form of Co-enzyme Q10, is also essential in cellular energy. I would recommend at least 50 mg per day, but more (like 100 or even 200 mg) would probably be better.
  • Vitamin B12 is crucially important for health. And the older we get, the more critical it becomes. I get an injection of 5 mg every month, and recommend that for everyone (see B12: your life depends on it).

Keep in mind that the timescale for improvements is long: on the scale of months. If you think that is too slow, ask yourself how old you are, and how long it took to get to the state you’re in. Now, with the answers in mind, remind yourself to be patient. You need to be determined to get better, consistent with your new regimen, and patient. But I assure you that you will get better. And please, keep me posted on your progress.

If you think this article could be useful to others, please Like and Share it.

Eat your salt, and eat your fat

A couple of months ago, I had just gotten to the locker room at the gym, when a buddy of mine came in. Changing into his workout clothes, looking at himself in the mirror with his shirt off, he said he was tired of this layer of fat over his abs, that he just couldn’t get rid of it no matter how much he tried. He’s a handsome Columbian guy in his mid thirties, super nice, friendly, and easy going, big open smile with nice white teeth. He’s well built, strong, with balanced musculature but … there’s not much definition.

Everyone wants to be cut, of course, and when you’re working out 5 or 6 times a week, like he does, and you can’t get cut, you get frustrated by that. Quite understandable. Meanwhile, I work out typically three times, and I’m “rallado” as he says to me. In english, the term is shredded: so lean that under tension, we see the muscles fibres. In my case, we can see them in every muscle, including the abs. He knew that, obviously, since I’ve been like this ever since we first met a year and a half ago. The only thing that’s changed is that I’ve put on some muscle and use heavier weights in my workouts.

And so, naturally, that was my queue:

– You just need to cut the carbs. The fat is going to melt off on its own in no time. Especially if you are working out the way you do. Just stick to meat and vegetables. Make it simple for yourself. Have eggs and avocados for breakfast, and meat and veggies the rest of the time. If you can skip breakfast, that’s even better: you’ll give your body a longer time to burn fat.

– Alright! I’ll try it!

After our workout, we said goodbye, and he told me he was going to Columbia for a while for his work (he’s part of a several-generation, several-family-member meat business based there, but lives here in Madrid with his wife and young child). He said that even though they always serve so rice, pasta, and potatoes with every meal, he would do his best to stick to the plan of having only meat and veggies. I gave him a good handshake, told him he could do it, and that it was important to be strict for the first month to allow for a good transition to fat-burning.

A few weeks later, he came back. We bumped into each other at the gym again. I was doing chest and back, he had come to do shoulders. He looked noticeably different: his face was smaller, his features more defined, his neck was thinner and more visible, his eyes were whiter and his skin was smoother. He looked 5 years younger! As soon as I saw him, I told him he looked very good, thinner in the face and neck, younger, and clearly healthier. He was happy to hear me say it, of course. He said that many people had told him that he looked younger, and obviously, he could also see it himself when he looked in the mirror. But it’s always nice when someone tells us we look good; it doesn’t happen very often. He had already lost 4 kg.

We saw each other a few more times at the gym like that, working out, but it took a while before he told me that he was feeling weak, that he couldn’t push as much weight as before, that he was often tired, and strangely, often in an angry mood. Naturally, he thought it was because he wasn’t eating carbs. That somehow he was carb-deficient.

– Do you add plenty of salt and fat with your meals meat and veggies?

– No! I don’t! I haven’t added salt to food in years. And I don’t add fat either.

– That’s the problem. You need to start right away. Lots of salt, and lots of fat with your food, whenever you eat.

– What kind of salt, and what kind of fat?

– Unrefined sea salt, organic butter and coconut oil, and olive oil with salads. With every meal. When you go low carb, you not only get rid of accumulated water in your tissues due to the chronic inflammation triggered by carbohydrate exposure (that’s why your face and neck thin out in the first week or two), but you also excrete more salt in the urine. It’s crucial to eat plenty of unrefined salt every day.

butterAndSalt

Organic butter and unrefined salt

 

Two days later, when I got to the gym, he was already into his workout, and he was pushing heavy weights on the benchpress, he was walking around with a spring in his step, and he was smiling. I didn’t even need to ask, but I did anyway:

– So, how are things going? Lots of salt and fat?

– Yes! And I feel great! I feel strong, I feel powerful, I’m not tired, and I’m not angry anymore.

– Fantastic! Glad to hear that. And from now on, you’ll always feel like this. No ups and downs, no weakness or lack of energy, no hunger pangs, no mood swings.

Each time we saw each other at the gym in the next weeks, I could tell he was getting more defined. The last time we met, he was again walking around feeling strong and working heavy weights with a smile on his face, and he looked ripped, a lot more defined. And he knew it too. I could tell by the self-confidence.

When we parted, I told him he looked good, that he looked more defined, and more energetic. He was happy: “Thanks a lot for all your advice. It’s really made a huge difference. I feel great, and my abs are starting to show!”

Not eating enough salt and not eating enough fat is a classic mistake that too many people do. We have been brainwashed into thinking we should avoid fats and we should avoid salt. So, when we cut the carbs, we continue to avoid fat and avoid salt. Then, we get tired and weak, and we think it’s because we don’t eat carbs. Totally not! We’re just not getting enough salt and fat.

And so, we have to repeat this, and repeat it over and over again. Eventually, it sinks in. Especially when we feel the difference it makes. Just like it happened in this case with my Columbian buddy at the gym. So, what’s the moral of the story?

You want to feel strong, and energetic? You want to look healthy and young? You want to get ripped with tight 6-pack abs? The formula is simple:

Cut the carbs. Fast intermittently. Drink alkaline water on an empty stomach. Work heavy weights 3 times a week. Eat enough protein. Eat your salt. And eat your fat. Try it. You’ll see. It works like a charm.

If you think this article could be useful to others, please Like and Share it.

Case study: old man can’t walk

Some time ago, a childhood friend of mine sent me this message:

I want to help this man. He has a problem with his tendons in both legs. In the morning, he can’ t stand up. Can you recommend some minerals and vitamins? Maybe some exercises that can help? Your advice is important.

oldMan

The old man that can’t walk from the pain in his legs.

That’s all he wrote. So, I replied:

How can I give any advice? I don’t know anything about him. I help/treat people with a complete eating and drinking programme. Vitamins and mineral supplements are only used as adjuncts to correct deficiencies. So, before saying anything, I need to know some basic things:

How old is he? What work does he do or did? How long has this problem been developing for? Does he drink water and how much? What does he drink? What does he eat every day? Does he have other complaints? How is his digestion? How is his skin (any rashes or dry skin or eczema)? What kind of other problems has he had in his life? And anything else about this health that could be useful?

Here’s what I got back:

  • How old is he? What work does he do or did?  He’s 81. He was a manager.
  • How long has this problem been developing for?  The problem started when he was around 65. It has gotten much worse in the past 2 years.
  • Does he drink water and how much?  He drinks little water, 0.5 litres a day.
  • What does he eat every day?  He eats meat, potatoes, tomatoes, some cheese, and a lot of bread.
  • Does he have other complaints?  Heart, kidneys.
  • How is his digestion?  He has problems going to the bathroom every day. He goes once every three days.
  • How is his skin (any rashes or dry skin or eczema)? His skin is fine.
His doctor told him to exercise, but he can’t even stand up or move properly.

With this info, I was able to get a better idea, and did my analysis of the situation.  This is what I replied:

Here is my diagnosis:
This man has been chronically dehydrated for most of his life. Being chronically dehydrated is one of the most health-damaging situation we can be in, but because it is not acute, the consequences are manifested over long periods of time. 
The lack of water first leads to a deterioration of the digestive system and digestive function: of the stomach (poor digestion and ulcers), and of the intestines (damaging of the lining, ulcers, and leaky gut), constipation and from it toxins and pathogenic bacteria going back from the colon into the bloodstream. 
Second, it leads to deterioration of the kidneys and the nephrons (little filters in the kidneys), because the only way to get the acids out of the blood is to dilute them in water, but if there is a lack of water, then the kidneys do everything they can to keep this water, because water is more important to keep than to get rid of acid. Therefore, not only do the kidneys get destroyed little by little, but the body accumulates the uric acid everywhere in the soft tissues, starting in the joints, and then in the tendons, ligaments and muscles. This leads to incredible stiffness, pain, and eventually to not being able to move.
Third, because our diet is usually rich in calcium but very poor in magnesium, everyone tends to be over-calcified and to accumulate calcium everywhere in the blood vessels, soft tissues of the joints, and in the muscles. This is made much worse by over-acidification and chronic dehydration. Calcification also leads to stiffness, pain, and eventually, to not being able to move properly.
Therefore, the most important things to do in order or priority are the following:
  1. Drink a lot more water (at least 3 litres per day), on an empty stomach (at least 20 minutes before eating), and making sure it is alkaline water (high pH 9-10).
  2. Take baths with 2 cups (500 g) of sodium bicarbonate and 1 cup of magnesium chloride (or magnesium sulphate). The bicarbonate and magnesium will be absorbed into the body through the skin, and will dissolve uric acid and calcium deposits throughout the body. 
  3. Drink juice of green vegetables to remove acid buildup in the body, and clean out the intestines.
  4. Take supplements of magnesium (the best form is L-Threonate, because it is bound to fat and is 100% absorbed) in order to help remove build-up of calcium.
  5. Take supplements of vitamins A-D-K2 (I recommend DaVinci’s combo supplement because of the high concentration of K2), as these are the most important fat-soluble vitamins, and K2 is the only nutrient that can effectively de-calcify blood vessels and soft tissues.
  6. Take supplements of vitamin C and collagen to help rebuild the cartilage and heal the damaged soft tissues, especially the blood vessels and the joints. It is essential to take whole-food vitamin C, and high quality collagen.
  7. Stop eating sugar, bread, cheese, yogurt, and eat basically very big salads and fatty meats like lamb, veal and porc (only outdoor-living animals).
Good luck, and make sure to let me know how things evolve. If you don’t understand something, just ask.

 

Three weeks later, I got his note from him:

Today I called the old man’s wife. She told to me that since yesterday he has no pain, and can move his arms and legs a lot better.  He drinks more than 2 litres of water per day, eats and takes the supplements as you prescribed. His grandson translated your message for him. I am very impressed. Thank you so much for you help. Your method works.

It’s a nice feel-good story, isn’t it? Here’s the thing, though. How many millions of people do you think are in the same situation as the one in which this man was? Suffering like he did, for decades growing older, stiffer, less mobile, and in more pain, until the end, which by that point comes as a relief from this difficult and painful life. And from what? Dehydration. Simple dehydration. Long-standing, chronic dehydration.

How much water do you drink each day? What’s the pH of the water you drink? How much salt do you eat each day? How much bread and potatoes do you eat? How is your digestion? How often do you go to the bathroom, and how is the wipe? Such simple things, so crucial to health.
If you think this article could be useful to others, please Like and Share it.

The Iodine Papers 2 – Orthoiodosupplementation

In this paper, the authors continue their investigation and quantitative assessment of how much iodine is needed for optimal health and function of the whole body. As the title emphasises, the primary aim in this paper is to determine the ideal amount of supplemental iodine in light of the fact that it is difficult to get as much as is needed through diet alone in most of the world.

The major themes are 1) what the authors have termed iodophobia, the widespread but entirely unfounded fear of iodine, which continues to pervade in the mentality of physicians, and consequently, in that of the general population; 2) iodine needed for optimal thyroid health; and 3) iodine needed for extra thyroidal tissues. Because the effects of prolonged iodine deficiency in cells leads to cancer, and because the second-most iodine-dependent tissues are those of the mammary glands of the breasts of females, much of the discussion is concerned with cancer of the thyroid and breasts.

The conclusion is the same as in their first paper: an optimal daily amount of iodine is around 12.5 mg of which 5 mg is in the form of iodine, primarily for the thyroid gland, and 7.5 mg in the form of iodide, primarily for the breasts and other extra-thyroidal tissues.

Orthoiodosupplementation: Iodine sufficiency of the whole human body by Guy E. Abraham, MD, Jorge D. Flechas, MD, and John C. Hakala, RPh

lifespa-image-iodine-pills-bottle

Supplemental iodine for optimal health of thyroid, breasts, skin, and whole body. Long-term average daily iodine intake according to authors should be at least 12.5 mg, and provide both iodine and iodide.

The paper begins with the authors’ motivations, presented clearly in the first two paragraphs. They contrast, on the one hand, that it is known and recognised that iodine is the only element required for and in the synthesis of hormones; that these hormones are involved in embryogenesis, differentiation, cognitive development, growth, metabolism, and regulation of body temperature; that iodine is most concentrated in the thyroid; that iodine is the most deficient trace element in the world with more than one third of the world’s population known to be clearly iodine-deficient; and that low iodine is the world’s leading cause of intellectual deficiency.

Whereas, on the other hand, that optimal amounts of iodine for the human body have never been evaluated nor determined; that supplementation has been considered adequate if it prevented cretinism, simple goitre, and symptoms of hypothyroidism; that it has been assumed that the role of iodine was essentially restricted to the synthesis of T3 and T4, so much so that it has become dogma; and that when thyroid stimulating hormone (TSH) assays became available, iodine urine testing was abandoned as irrelevant, and eventually forgotten to the point where today, most clinical doctors will go through the entire career without ever ordering a urine iodine test.

Iodophobia

The fear of iodine, which most likely has its roots in the work of Wolff and Chaikoff (1948), and which we will examine on another occasion, is present and widespread in the literature for all audiences. It is found in the textbooks used in medical schools, in professional journals, in non-technical publications that appear in health magazines, and in books written for the general public by medical professionals. The authors present a number of examples from different sources spanning this range of different kinds of publications intended for different audiences.

They seem to attribute much of the burden for the spread of iodophobia in the US, at least in the last few decades, to one individual, an endocrinologist by the name of Ridha Arem, who was a longtime editor of a professional periodical read by at least 25k endocrinologists throughout the country, and the author of the popular book The thyroid solution: A revolutionary Mind-Body program that will help you, first published in 1999 and currently in its third edition (2017).

In this book, on page 305 of the 1999 edition, Arem writes: “research has clearly established that the high dietary intake iodine content in some areas of the world has resulted in a rise in the prevalence of thyroiditis and thyroid cancer.” A single reference is given in support of this statement: a paper written by Harach & Williams, entitled Thyroid cancer and thyroiditis in the goitre region of Salta Argentina, before and after iodine prophylaxis, and published in 1995 in the journal of Clinical Endocrinology (43:701-6). In this paper, however, no high iodine intake is present or involved in any part of the study.

Harach & Williams (1995) measured urine iodine before and after introduction of iodised salt, and evaluated thyroiditis and thyroid cancer rates. Urine iodine was 9.3 +/- 1.7 mcg/g creatinine before and 110 +/- 13 mcg/g of creatinine after iodisation. There was no change at all in the rates of invasive forms of cancer, and for papillary carcinoma the numbers were 0.78/100k/year before and then 0.84/100k/year after iodisation, which they recognise as insignificant. Not only do these data not support Arem’s claims, but they are not even applicable to an evaluation of the potential effects of high iodine intake. Arem does not provide any other references.

On the same page Arem also writes: “to function normally, the thyroid requires 150 mcg/d … In the US, iodine consumption ranges between 300-700 mcg/d.” No reference is given to support this statement. And this statement is demonstrably false: the National Health and Nutrition Examination Survey, NHANES III (1988-1994), showed that the median iodine in urine was 145 mcg/L, and that at least 15% of US women were markedly deficient, with less than 50 mcg of iodine per litre of urine.

The reason why measuring iodine in urine over 24 hours is a good way to evaluate iodine sufficiency, is because most of it is excreted. If the body’s tissues (thyroid glands, breasts, stomach lining, skin, etc) have all the iodine they need, then we would excrete close to the entirety of the iodine we consume. The greater the discrepancy between ingested and excreted iodine, the greater the deficiency. But because it is water soluble and hard to store, a long time is needed to replenish iodine stores in the tissues. Hence, for this reason, supplementation with larger doses than those needed for optimal maintenance, and extended over many years, are usually needed to restore iodine sufficiency and balance within the body’s most iodine-dependent tissues like the thyroid, breasts, and skin.

In a review paper on iodine ‘excess’ published in 2000 and included in a reference textbook used by endocrinologists in a section entitled Iodine as a pathogen, Roti & Vegenakis the authors report the decline in iodine intake in the US, stating that in 1971-74, it was found that 27.8% of people tested excreted more than 500 mcg/L, whereas in the intervening 15-20 years, this number dropped to 5.3% (1988-1994). Having taken—entirely arbitrarily—500 mcg/L as indicative of excess iodine, the authors present these figures as encouraging and positive in the prevention of iodine ‘excess’, completely ignoring the remarkable discrepancy with the observations of mainland Japanese that show both an iodine intake that is 100 times greater than the US average, and the lowest incidence of goitre and hypothyroidism: figures presented by Finley & Bogardus in 1960, and more recently also in further studies by Thomas et al. in 1983 and 1986.

Moreover, in their review, Roti & Vegenakis note that Amiodarone, a drug commonly used to treat heart arrhythmia, contains 75 mg of iodine per 200 mg tablet (note that this is mg and not mcg), and causes hypothyroidism in 25% of patients that take it. They automatically attributed this to the iodine, but do not investigate the issue further, either by looking at studies on high iodine intakes, or by themselves organising a trial to test this hypothesis, treating arrhythmia using iodine alone without the other pharmaceuticals found in Amiodarone. No such trial has ever been carried out, by the way. Only comparisons between different pharmaceutical drugs.

As a third example of iodophobia and misinformation about iodine in the US, the authors use Dr Shames’s article in the July 2002 issue of Bottom Line Health magazine, and debunk three statements of fundamental significance:

1) Shames writes that iodine deficiency is a thing of the past. However, as mentioned above, NHANES III (1988-1994) found 15% of women to be iodine deficient.

2) Shames writes that iodised salt is sufficient to prevent iodine deficiency. However, iodised salt contains at most 75 mcg of iodine per gram, and since most people eat around 5 g/d, this makes at most 375 mcg/d. This amount may be enough to prevent cretinism and goitre, but to obtain even the bare minimum of 5 mg needed by the thyroid, one would have to eat 65 g of iodised salt per day, which is obviously absurd.

3) Shames writes that people living near coastlines could even be getting too much iodine. However, studies in several countries found no difference in iodine intake between inland and coastal regions.

The unfortunate reality is that all those people who will have read either Arem’s books, Roti & Vegenakis’s reviews, Shames’s articles, or any other published works expressing in similar terms, from a position of authority, statements unsupported by evidence or simply and demonstrably false, will rarely be in a position to question or doubt their validity, and will therefore be left with the entirely unfounded negative predisposition towards iodine transmitted by the authors of these publications.

Iodine for the thyroid gland

The cold war was a period during which the fear of nuclear war, and the subsequent nuclear fallout that would sweep across the region around the explosion was very strong. This fear was shared by most people: parents and grandparents, political leaders and scientists. It was known that the thyroid concentrates iodine: more than 100 times the concentration of other organs and tissues (modern measurements in Delange 2000). It was also known that nuclear fallout would come with a release of large amounts of radioactive iodine in the environment. The nuclear explosion was therefore, in its immediate aftermath, most dangerous for its devastating effects on the thyroid: the thyroid gland would soak up all of that radioiodine, which would destroy it, breaking down its cells from within.

The only way to prevent the thyroid from soaking up all that radioactive iodine from the nuclear fallout would be to fill up the receptors of its cells with normal iodine, and thereby minimise the capture of the radioactive isotopes from the explosion. Because iodine is water soluble and not stored very well, to both provide the thyroid with the iodine it needs and protect it from radioactive iodine in the case of a nuclear accident, one would have to take moderately high amounts of iodine every day, or a very large amount as soon as possible before, during or after exposure, and continue for the early period following the explosion, until the levels of radio iodine contamination have dropped. The iodine receptors in the thyroid, breasts, and other tissues being occupied by normal iodine, the radioactive isotopes would have nowhere to latch on, and would therefore simply be excreted in the urine.

Studies were carried out to determine the amount needed to suppress uptake of radioactive iodine. A defined amount of supplemental iodine would be taken, and then a fixed amount of radioiodine administered. Measuring the amount of radioiodine retained by the thyroid in proportion to the amount administered would give the protection factor associated with the amount of supplemental iodine.

Several groups did such experiments. The results of five groups are presented in Figure 1 below. On the x-axis, we have the amount of iodine in mg consumed per day. On the y-axis, we have the percentage of radioiodine taken up by the thyroid. Naturally, the less iodine is consumed, the higher the percentage of radioiodine retained by the thyroid, and conversely, the more supplemental iodine is taken, the lower the percentage of radioiodine uptake.

uptake

Figure 1.  Percentage of radioactive iodine absorption as a function of daily iodine intake. The data are those presented in Table 1 and Figure 1, and the original papers from which they were taken are listed and represented with different symbol. The RDA range is shown by vertical lines at its lower and upper limits of 150 and 290 mcg. The data are presented on a log-log scale. The best fit power-law model is shown as the dashed line, and its parameter values are given.

The greatest protection is conferred by the highest amounts of supplemental iodine, as we can see on the right end of the scale: taking 100 mg/d results in a mere 0.5% uptake, and implies excretion of 99.5% of the radioactive isotope of iodine. At 50 mg/d, uptake is around 1.5%, and excretion around 98.5%. At 20 mg/d, uptake is still below 2% with excretion over 98%, and even at 3 mg/d, uptake is only around 5%, with 95% excretion of the radioactive iodine.

The scale, both on the x-axis and on the y-axis, is logarithmic. This means they have equal spacing in powers of 10. And so, the tick marks between 0.1 and 1 represent steps of 0.1, those between 1 and 10, represent steps of 1, and those between 10 and 100 represent steps of 10 units. The units are mg on the x-axis, and percentage points on the y-axis. A linear relationship (a straight line) in log-log space, as the one we see in this plot, shows to a power-law relation, and power-laws tell us that change is very fast.

In this case, this tells us that increasing iodine intake from nothing to even a little bit, makes a big difference in terms of decreasing the uptake of the radioactive iodine. On the other hand, it also means that as we keep increasing the amount of supplemental iodine, the decrease in uptake becomes less and less significant. Hence, it is very easy to protect the thyroid against nuclear fallout by decreasing uptake of radioiodine from 100% to 20% by taking just 0.7 mg of iodine per day, but to get maximum protection, we need to take 50–100 mg/d. The great news is that we can get full protection, without having to worry about a thing from all this supplemental iodine, because it is basically harmless, and excesses are eliminated.

The authors present these data (together with other data that we don’t discuss here) in a table, and then in a graph, which is logarithmic only in x, but linear in y. Therefore, they interpret the relation—which is clearly linear in log-log space, but not in semi-log space—as showing evidence of four different parts with different slopes and different physiological meanings. I believe the single power-law is both simpler and more natural a model to characterise the relationship between supplemental iodine and radioactive iodine uptake by the thyroid. I therefore skip reporting on the details of their analysis of the slopes and x-axis intercepts and interpretation of their meaning.

In addition, the authors rightly point out that none of these studies were intended to measure the optimal amount of supplemental iodine. They were motivated by providing a framework for crisis management in the event of a nuclear war. Nevertheless, their scientific value in understanding iodine needs for optimal thyroid function is indeed great. Other studies intended on measuring thyroid absorption of iodine are mentioned: those of Thompson et al (1930), Wagner et al. (1961), and Fisher et al (1965), all pointing to a maximal absorption rate of iodine of about 600 mcg/d. This is interesting, but not enough because absorption rate will depend on state of deficiency or sufficiency, and will also evolve as iodine levels are replenished, assuming more iodine is provided than is absorbed. But two other cases stand out.

Plummer, a clinician who treated people suffering from Grave’s disease, a severe form of goitre, hypothesised that the hyperthyroidism associated with this condition was caused by iodine deficiency, and furthermore, that it was this deficiency that also caused such a high post-operative mortality rate. He therefore gave his patients 20-30 drops of Lugol’s solution before and 10 drops after operations—that’s 125-187.5 mg before and 62.5 mg after—and happily saw the mortality rate drop to zero. Of course, this didn’t prove his hypothesis as correct; this is never really possible in science. But it is strong supporting evidence, and did show that it was highly likely to be the case. And given that he knew iodine supplementation was harmless, he also knew that it could only help. He was right, and the benefit to his patients couldn’t have been greater: it was life over death. It was, naturally, an easy decision to make. He knew that, and now, so do we.

Koustras et al (1964) performed extensive studies with meticulous accounting of iodine balance on people to quantify the relationship between the amount ingested and retained over a period of several weeks with daily supplementation. This is what they concluded: “From our evidence, it appears that, from all the doses we used, the thyroid took up about 6-7 mg of iodine before an equilibrium in plasma inorganic iodine was reached.” This seems to be, from several lines of evidence, a good estimate of what the thyroid needs.

Iodine for the mammary glands and other tissues

Having established that the thyroid needs 6-7 mg of iodine per day, the authors need to estimate how much is needed by the rest of the body. Because breast tissue concentrates as much iodine as the thyroid, and because, as reported previously, goitre is six times more—that’s 600% more—common in teenage girls as it is in teenage boys, it is essential to consider iodine needs of the mammary glands. Here are some facts the authors present that are associated with the problem of iodine deficiency in women:

  • Japanese have the world’s highest intake of iodine (14 mg/d from 5 g of seaweed, on average), and the lowest incidence of goitre, hypothyroidism, and breast cancer (Finley & Bogardus 1960; Thomas et al 1983, 1986).
  • There is a strong inverse correlation between iodine intake and cancers of the breasts and ovaries, and a strong positive correlation between thyroid volume and breast cancer incidence: 13 ml in Irish women without versus 20 ml in women with breast cancer (Thomas et al 1983, 1986).
  • There is a strong inverse correlation between free T4 and breast cancer. In 5 different ethic groups from Hawaii, Britain and Japan, the highest levels of free T4 in Japan were associated with the lowest incidence of breast cancer. But T4 therapy doubles incidence of breast cancer. Therefore, it is obviously not T4 that protects against breast cancer in Japanese women, but iodine, which, at the same time, ensures optimal T4 levels. (Ghandrakant, Kapdim & Wolfe 1976; Hinze et al. 1989)
  • The amount of iodine needed to prevent FDB and breast cancer is at least 20-40 times greater than what is needed to prevent goitre (Esquin et al. 1995).
  • Thyroid and skin concentrates iodide; breast concentrate iodine. Both are needed.
  • US intake is about 100 times less than in Japan. In the 1960’s iodine was used as an anti-caking agent in flour, which made the average intake approximately four times greater than it is today. Incidence of breast cancer was then 1 in 20. Iodine in flours was replaced by iodine-displacing bromine. Incidence of breast cancer in 2000 (publication date) reported as 1 in 8.
  • Iodine deficiency is without a doubt just as important a cause of thyroid cancer as it is of breast cancer. In 2001 in the US, there were 19500 new cases of thyroid cancers, and of these, 14900 were in women. That’s 75%. Now, in 2017, estimates are for 56870 new cases of which 42,470 will be in women. That’s still 75%, and it’s also about 400% more cases than 15 years ago.

To determine with the greatest precision where iodine is most concentrated within the tissues of the body, and how much is kept, Berson and Yallow (1954) used traceable radioiodine to determine, in addition to what has already been discussed about iodine being most concentrated in the thyroid, breasts, and skin, that the total exchangeable pool of inorganic iodine ranged from 7 to 13 mg across their study. This means, that besides those most iodine-dependent tissues that trap and concentrate it, the body as a whole uses at least this amount on a daily basis.

Given this large amount used by the whole body, iodine must have several other functions besides protecting the structure and ensuring the proper physiology of the thyroid and breasts. Derry (2001) reviewed iodine’s general properties and benefits to a healthy body. He found that iodine works in organs as an antimicrobial agent, that it has a potent apoptotic function in the body’s surveillance mechanisms against abnormal cells, that it has the ability to trigger differentiation, and that, in addition, iodine has powerful antioxidant properties, which confer it equally powerful protective effects on the DNA of cells, because it enhances the singlet to triplet transition, and because the most damaging reactive oxygen species that damage our DNA and other large molecules are usually singlets.

Naturally, these effects strongly depend on the concentration of the available iodine circulating in the fluids of the body. Using fluid concentration measurements in the work of Szent-Gyorgy (1957), the authors estimate that an average daily intake of 12.5 mg of iodine, which at the same time, they underline, would offer protection from nuclear fallout at the 3-4% level, would also be sufficient to confer all of iodine’s antimicrobial, apoptotic, antioxidant and DNA-protecting effects.

Epilogue

The paper ends with an epilogue where the authors express some difficulties in understanding, in the context of evolution, why humans would have evolved needing so much iodine while recognising how hard it is to obtain as much as is needed. In my opinion, there is no difficulty there from the perspective of evolutionary theory. The first homo sapiens in our lineage, those that developed speech, swept across the world, and came to dominate every last part the planet, in all likelihood evolved on a coastline somewhere in south western Africa eating seafood and seaweed. Many believe that it was their diet, rich in animal foods from the sea that gave them this advantage over other species and even other sub-groups of sapiens scattered here and there on the continent. In fact, it is very likely that it was their iodine-rich diet that conferred to them this evolutionary advantage, which was the intelligence for which sapiens are known.

For most of our evolutionary history, bands of humans would have continued to live near coastlines because of all the obvious advantages this offered. As local and global populations grew, bands would scatter in search of more readily available resources and less competition in their ability to access and use them. Those groups that stayed on the coastlines or in areas where the soil was rich in iodine, became the most successful because they were the most intelligent. Those groups that went further inland or lived in areas where the soil was poor in iodine, grew progressively less intelligent and less successful from one generation to the next.

There is no problem at all with such a scenario, and, in fact, modern observations and data collecting techniques confirm this: areas where iodine deficiency is common, have the highest incidence of hypothyroidism, goitre, breast cancer, thyroid cancer, but also cretinisms and intellectual deficiency. As attested by a joke used in some towns in the goitre belt when someone does or says something stupid: “Are you iodine deficient, or something?”

It wouldn’t at all be surprising if, with sufficiently large data sets, we found a strong and tight correlation between iodine intake and IQ levels within populations from the same genetic pool, but also globally across diverse populations from different gene pools. Many other factors come into play. Nevertheless, iodine during pregnancy and childhood is certainly one of the most important for proper intellectual development.

For us, each with our own particular genetic makeup and recent ancestral evolutionary history, each with our personal and family history, each with our time in our mother’s womb, our childhood and teenage hood upbringing and diet, what this means is that we better make sure we take all the iodine we need to first correct, and then prevent the wide spectrum of problems that iodine deficiency and iodine insufficiency bring about. Might as well maximise our health as well as intellectual potential in this simple way. The costs are insignificant, the risks quasi non-existent, and the potential benefits are tremendous.

Summary

This paper is very similar in spirit and purpose to the authors’ first paper. In this second paper, they recall and restate several points they had made in the previous, and extend their detailed investigation of how much iodine is needed for optimal health and function of the whole human body. The main points to remember are that:

  • The fear of iodine is widespread, but wholly unjustified and unfounded.
  • Iodine is most highly concentrated in the thyroid gland.
  • Iodine is essential and crucial for the normal development, and subsequently, normal function of the brain through its action on the thyroid gland.
  • Iodine deficiency is the world’s leading cause of intellectual deficiency.
  • In females, iodine is equally concentrated in the breasts as it is in the thyroid.
  • Iodine deficiency is known to cause cretinism and intellectual deficiency, hypothyroidism and goitre, nervousness, anxiety and restless leg syndrome, fibrocystic breast disease, thyroid cancer, and breast cancer.
  • Iodine deficiency causes goitre in women 6 times more often than in men.
  • Breast cancer now affects 1/8 women. In the 1960’s it affected 1/20.
  • Thyroid cancer rates have quadrupled in 15 years from 2001 to 2016.
  • 75% of thyroid cancer cases are in women.
  • The thyroid gland needs approximately 6 mg of iodine per day.
  • The mammary glands and rest of the body need approximately 6-8 mg per day.
  • The Japanese are the only known population with iodine sufficiency from diet, which provides on average 14 mg of iodine from seaweed.
  • Minimum average requirement for iodine sufficiency is around 12.5 mg/day.
  • As is the case for most micronutrients, some people need more, some less.
  • It will often be necessary to consume a lot more for extended periods in order to overcome and/or reverse the effects of a long-standing insufficiency or deficiency.
  • Maximum protection of the thyroid from nuclear fallout is gotten at 50-100 mg/day.

We will continue this series with an article by the same three authors entitled: Measurement of urinary Iodine Levels by Ion-Selective Electrode: Improved Sensitivity and Specificity by Chromatography on Anion-Exchange Resin.

If you think this article could be useful to others, please Like and Share it.

No more bipolar disorder?

Our world is replete with diseases of all sorts, illnesses of all kinds, ailments countless in numbers. Modern medicine views these in isolation, and therefore also attempts to treat them in isolation: we have a headache, we take an aspirin; we have high blood sugar, we take insulin injections; we have high cholesterol, we take statin drugs to disrupt the manufacturing of cholesterol in the liver; we have cancer, we are given toxic poisons that kill our cells and hope the cancer will be weakened; we have arthritis or multiple sclerosis, and we are given immune suppressants because it is thought that our own immune system has turned against us, attacking the very body it is intended to protect. We have no idea why, but this is what we do, and this is also what we believe we should be doing.

In psychiatry, we treat so-called mental illnesses. But because we are even more clueless in this realm of the subtle functioning of the brain and mind than we are of the subtle functioning of the body and its organs, we look for drugs that suppress the behaviours which are symptomatic of the “illness” we have been diagnosed with. It’s very simple: we take uppers and stimulants when we are down and low, and downers and sleeping pills when we are high and excited. Because we all do it, we think it’s perfectly normal.

When we take a close look, we see that there are no diseases, no illnesses, no ailments that are not caused by biochemical imbalances; we see that all of our health problems are rooted in problems in the biochemistry; and we see that the functioning of the body and the functioning of the mind cannot be considered independently, because they are both nothing other than the functioning of the whole body-mind.

Surely a most striking example of this is the now almost forgotten disease condition called pellagra. The name comes from the contraction of the Italian pelle (skin) and agra (sour), and was first used by Francesco Frapolli treating people in the 1880’s in Italy where more than 100 thousand suffered from it. But this wasn’t unique to Italy. The same was true in Spain and in France in the late 19th century. In the US, it reached epidemic proportions in the American south where it was estimated that between 1906 and 1940, more than 3 million were affected, and more than 100 thousand actually died from it.

Can you image that? This many people—millions of people—in quite a restricted region, walking around in manic states, delusional states, paranoid states, seeing and hearing things, talking or even yelling to themselves and others around them, completely incoherent and, in addition, covered in red, sore, flaking and bleeding skin on the arms, neck, and face? What a nightmare it must have been.

In all countries and all cases, pellagra was associated with poor nutrition, and more specifically, associated with corn-based diets in which the maize was not treated with lime in the traditional way. Similarly, in all countries and all cases, it was found that a nutritious diet based on fresh animal foods very quickly resolved the problems that afflicted the sufferers of this disease. So, even in the late nineteenth century, they had figured out how to treat and prevent it. The thing is, though, they didn’t know why if they replaced the corn and starches with meats and vegetables, people got better.

Pellagra would usually first manifest as skin problems: eczema and psoriasis-like irritations and lesions. Then, it brought about anxiety, depression, irritability and anger. And eventually, periods of full blown mania, visual and auditory hallucinations, extreme fear, paranoia, bipolar and schizophrenic behaviours.

Bipolar-Disorder-Mood_scrabbleLetters

Now, if you know someone, if you have been close to someone diagnosed with bipolar disorder, with schizophrenia, with anxiety disorders, depression, or paranoia, you will immediately recognise in this list of symptoms those you saw in this person, surely to different degrees, and surely in the most extreme during a full blown crisis. Without a doubt, at least for bipolar disorder, these symptoms are all present, often simultaneously, and sometimes in close succession.

And do you know what pellagra is? It’s vitamin B3 deficiency.

Yes, pellagra, this terrible disease that caused such awful skin conditions and straight out madness in people, this disease that made these poor people act in ways indistinguishable from those of manic-depressives and schizophrenics, was a simple vitamin B3 deficiency.

When this was understood, niacin fortification was mandated, and the epidemic affecting millions of people in the southern United States was resolved almost instantly. After decades of rampant “mental illness” among so many—so much fear, so much anxiety, so much terror within families and communities, so much pain and suffering, and tens of thousands of deaths—a little added niacin ended this national disaster that was the pellagra epidemic almost overnight. The fact that you have most likely never heard of pellagra goes to show how effective niacin fortification has been in preventing it. But something else happened.

Following the introduction of niacin fortification, half the patients held in psychiatric wards were discharged. Just like that, they got better, and went home. There was at least one psychiatrist who noticed this remarkable coincidence: his name was Abram Hoffer. He wondered why so many got better, but also why only half. What about the other half? Could it be that they just need a little more niacin? Hoffer was an MD, a board-certified psychiatrist, and a biochemistry PhD. He was also the Director of Psychiatric Research for the province of Saskatchewan in Canada, a position he held from 1950, when he was hired and appointed by the department of public health, until 1967, when he opened a private practice.

What he did to check this hypothesis—that maybe more of the psychiatric patients were not mentally ill at all, but just in need of greater amounts of niacin—was to conduct a study. He chose schizophrenics because they are among the most difficult to treat, and also because together with bipolar patients, they have many of the symptoms associated with pellagra. The results were stunning: 80% of the schizophrenics given B3 supplementation recovered. And these results aren’t anecdotal—the word often used in a pejorative or derogatory manner to dismiss important observations or evidence that fall outside the narrow realm of the conventionally accepted. These were the results of the first double-blind placebo-controlled nutrition study in the history of  psychiatry.

What double-blind placebo-controlled means is that he took two equally sized groups of people diagnosed with schizophrenia, and then randomly and blindly, both on the patient’s end as well as on his end, gave half of them 3000 mg of flush-less niacin per day in three doses. (Niacin has a flushing effect that would be noticed, but either inositol hexanicotinate or niacinamide can be used instead.) He gave the other half a placebo, which would have been a pill that looked identical, but contained no niacin or anything else that could have any significant effect on them, (like powdered sugar or a starch of some kind). And at the end of the trial, when they looked at which patient got what, they found that 80% of niacin-treated recovered, whereas none in the placebo group showed significant improvements.

Over the years, Hoffer treated thousands of people with remarkable success. With simple vitamin B3 supplementation he continued to successfully treat people suffering from schizophrenia, but also people suffering from attention deficit disorder (ADD), general psychosis, anxiety, depression, obsessive-compulsive disorder (OCD), and bipolar disorder. In fact, he considered pellagra, bipolar disorder, and schizophrenia to be the manifestation of niacin deficiency on different scales, and the sufferers to be niacin-dependent to different extents. Obviously, this is the only natural conclusion he could have drawn given how effectively niacin resolved psychiatric symptoms in these people, but also in light of the fact that each individual seemed to need somewhat different amounts to have these positive effects.

The expression niacin-dependent was used to emphasise that they needed to take it on a daily basis. Naturally, an essential vitamin is not only essential in the sense that it is absolutely needed, but also in the sense that it needs to be consumed regularly because it is not manufactured within the body. Deficiencies develop when the diet lacks in these essential nutrients, and grow more severe as time goes on. When the nutrients are then reintroduced, the deficiencies can be corrected. Some nutrients are abundant, some are rare. Some are easily absorbed, some are not. Some are more easily stored, and some cannot really be stored at all.

In addition, besides the fact that in any given population there is always—for the very same essential nutrient—a range of nutritional needs that vary between individuals based both on their genetic predispositions and on what they do, countless other factors influence and affect the amounts of essential nutrients that each one of us needs to be healthy. These include various kinds of injuries to the body-mind, and in particular to the gut where absorption of nutrients take place, that may have incurred at one point or another from an infection, a virus, a bacteria, a bad diarrhoea we had when we were babies, a childhood disease we don’t even remember, and really anything that could have damaged a specific part of the intestine where a specific family of nutrients are absorbed.

Any such injury could result in a greatly increased need for a particular nutrient that, without knowing about it, could not be supplied in adequate amounts from diet alone, and would inevitably develop into a progressively more severe deficiency whose effects on the body-mind would eventually appear as dysfunctions that would, without a doubt, have physical as well as psychological or psychiatric manifestations. Why? Because there is no body that functions independently of the mind, and there is no mind that functions independently of the body. There is only this single body-mind.

Niacin and B vitamins in general are water-soluble. This means that we pee most of them out, and that we therefore need to have them every day, or nearly, in order to prevent the development of deficiencies. The experience from the last decades of the nineteenth and the first five decades of the twentieth century in Spain, Italy, France, and  in the US, showed that a single vitamin deficiency, a simple niacin deficiency, could cause extreme symptoms that included severe psychiatric dysfunctions. It also showed that even very small amounts of B3 added to the otherwise nutrition-less white bread that was eaten as a staple could cure millions of pellagra sufferers, and prevent the disease from developing in the bulk of the population.

Unexpectedly, niacin-fortification coincided with a large number of the psychiatric ward patients getting well enough to go home. This observation prompted a study with niacin supplementation which showed that in 80% of the schizophrenia patients treated with niacin, symptoms disappeared in the same way they had in pellagra sufferers, but with higher doses of niacin. It was also shown that a similarly high cure rate was seen in people suffering from ADD, psychosis, anxiety, depression, OCD, and, in the point we wanted to emphasise in this article, bipolar disorder. In almost all cases, niacin supplementation resolved the dysfunctional behaviours and psychiatric symptoms. What varied were the amounts of vitamin B3 needed to achieve recovery, and the speed with which symptoms would come back upon interruption of the supplementation.

Therefore, whether you are among the lucky people who never were niacin deficient, among the lucky people who need little niacin, or among the less lucky ones who are deficient, who do need more of it than most, or who are suffering from anxiety or depression, schizophrenia or bipolar disorder, doesn’t it make sense to just start taking a little bit of extra B3 each day? Doesn’t it make sense to give your body-mind the amount of vitamin B3 it needs, recognising that for each one of us this amount may be different, that for some it will be a lot more than for others, but resting in complete assurance that no ill effects will come from it, because niacin supplementation is harmless, and that the only disadvantage of it being harmless, even in large doses, is that we need to take it daily?

Given how inexpensive any form of niacin is, shouldn’t we be giving it in large amounts to every patient in every hospital, psychiatric ward, and medical institution? We should, but this will probably never happen. What we can do is take care of ourselves, of those people closest to us like our children and spouses, siblings and parents; of those people we care about like our friends and colleagues; and even of those people who are simple acquaintances who come to us for advice or just to share their concerns about a health issue. And one of the simplest and most effective things we can do to improve our own health and the health of those around us is by taking a little B3 supplement every day. It could just make you feel more relaxed, more focused, calm and at ease, as it does for me, or it could completely transform your world, bringing you from a state of hyper-anxious, paranoid, delusional and hallucinatory mania, back to a relaxed, helpful and trusting, conscientious and reasonable self, giving you the gift of your own life back to yourself.

Could it really be this simple and this amazingly miraculous? No more pellagra, no more schizophrenia, no more bipolar disorder, just with a little B3 supplementation? Well, maybe. You try it, and let us know.

The Iodine Papers 1 – Optimum iodine for the whole body

I will review a collection of research papers written by Guy Abraham (mainly), several of them with David Browstein, Jorge Flechas, John Hakala, individually and in different combinations, one paper with Nicholas Calvino, and another with Roxane Handal. They were published in The Original Internist between 2002 and 2008.

These papers form the backbone of the science and clinical evidence that has brought about the resurgence of the therapeutic use of iodine in natural medicine, and together with it, tremendous benefits to thousands of people who have recovered their health from supplemental iodine. I will, in the process, probably review some of the papers that are referenced. My intention is to present a detailed summary of each one of these papers as a series that we’ll call The Iodine Papers. This is the first:

Levels of Iodine for Greatest Mental and Physical Health  by Guy E. Abraham, MD, Jorge D. Flechas, MD, and John C. Hakala, RPh

seaweedsaladinbowl_cropped

The question posed by the authors is a simple one:  what are optimal levels of iodine for overall health. But seeking the answer in the published literature, they discovered that there wasn’t one. This paper has three logical parts. The first is a long introduction that includes a review of several historical studies in which they seek to find clues as to what would be the optimum amount to take on a daily basis; optimal meaning not too little, and not too much. The second part is the presentation of the results of a three-month study they did on ten American Caucasian women taking supplemental iodine. And the third is the discussion and conclusions, that naturally includes their proposal for what constitutes the optimal amount of iodine we should have daily.

For those (like you M) who are not interested in the details, but just in the answer, in this case it’s 12.5 mg per day, in the form of 5 mg of iodine and 7.5 mg of potassium iodide because the two different forms are needed by different tissues. For those of you who are interested, I’ll present the contents of the paper in the structure outlined in the previous paragraph.

Introduction and previous studies

In a 1998 editorial in the Journal of Clinical Endocrinology and Metabolism entitled What’s happening to our iodine?, it is stated that one third of the world live in iodine-deficient areas, and that iodine-deficiency is the leading cause of intellectual deficiency (mental retardation).

The earliest studies that are reported are from the 1920’s, one by Marine in Ohio, and one by Klinger before him in Switzerland. Klinger’s was performed in an area of the country that had, at the time, an 82–95% incidence of goitre in its population. Goitre is an enlargement of the thyroid gland due to iodine deficiency. Obviously a very serious problem. The study comprised 760 teenagers, of which 90% (684) had goitre. They received between 10 and 20 mg of iodine per week, which equated to an average of 1.4 to 2 mg/day. Fifteen months later, none had experienced adverse effects of any kind, 472 (69%) had recovered, but 212 (28%) still had an enlarged thyroid. The government therefore opted for a slightly higher dose, advising supplementation with 3–5 mg of iodine per day.

Marine did his study in Akron, Ohio, where the incidence of thyroid enlargement was not as high, but still 56%. Goitre appeared most often in puberty and six times more often in girls than in boys, and six times more often means 600% more. That’s a huge difference. They therefore used only girls. This study was much larger, and everyone started the programme with no signs of thyroid enlargement. 2190 received iodine supplementation, and 2304 were used as controls and didn’t get any.

The programme ran for 2.5 years, with 5 periods of supplementation, one in the spring and one in the fall, in which the participants were given 200 mg of sodium iodide per day for 10 days. If we calculate a daily average out of those total of 4 grammes per year, it gives 11 mg of sodium iodide, and thus something like 8 mg of iodine. At the end of the 2.5 years, 495 out of 2304 (that’s 22%) in the control group had developed goitre, compared to only 5 out of 2190 (that’s 0.2%) in the supplementation group.

In 1966, two Russian scientists hypothesised that pathologies of the breasts in women could be caused by excess oestrogen from ovarian cysts due to insufficient iodine. They took 200 patients with what they called “dyshormonal hyperplasia of the mammary glands”, and gave them 10–20 mg of potassium iodide per day for periods that varied between six months and three years. Within three months a majority experienced significant improvements with decrease in pain, swelling and nodularity. In the 167 who completed the programme, 72% experienced significant improvements. Five patients who had ovarian cysts saw them reduce in numbers and size.

Then in 1976, a group of Canadian researchers led by Ghent, extended this study on women with breast disease, and tried different forms of iodine supplements in different amounts on three different groups. They had 233 women on 30–60 mg/day from a 5% Lugol’s solution for 2 years, 588 women on 10 mg from iodine caseinate for 5 years, and 1365 on 3–6 mg/day from saturated aqueous iodine solution for 1.5 years.

Clinical improvement—both subjective in terms of pain, swelling, discomfort; and objective in terms of reduced fibres and nodules—were seen and measured in all three groups, but with different success rates:  74% in the group using the saturated aqueous iodine solution (3–6 mg/day), 70% in the Lugol group, and 40% in the iodine caseinate group. Moreover, different numbers of women reported adverse effects from the supplementation: 11% in the aqueous iodine group, 7% in the Lugol, and 9.5% in the caseinate group.

Notably, the authors reported on the results of autopsies performed in 1928 and in 1973. Evidence for fibrocystic disease of the breast (FDB) was present in 3% of women in 1928. In 1973, FDB was present in 89% of women. That’s 9 out of 10 women back in 1973. Do you think the magnitude of the problem has decreased since? Not likely.

In Japan, Nagasaki and colleagues published in 1967 the results of their investigation of the relationship between iodine consumption and disorders of the thyroid and breasts. They surveyed different regions, some mainland and some coastal, and found an average daily consumption of seaweed of 4.6 g in mainland areas, which translated into 13.8 mg of combined iodine and iodide. Inhabitants of coastal areas had an even higher daily consumption of iodine. Investigation into the function of the thyroid supplied iodine in the amounts ingested in coastal areas showed that it absorbs more than it secretes as T3 (triiodothyronine) and T4 (thyroxine) whose levels remain in a narrow physiological range, and that the rest, the amount unused in making T3 and T4, is secreted as inorganic iodine, presumably to be available in that form to other tissues. The reason why this was an important study is that Japanese women consuming this amount of iodine, have very low rates of thyroid and breast disorders.

Finally, maybe as a remnant and reminder of the importance of iodine in medicine up to our current era of drug-based medicine, the authors make note of the fact that in the 1995 version of the standard reference Remington’s Science and Practice of Pharmacy, the 19th edition of this work (now in its 21st), which “for over 100 years has been the definitive textbook and reference on the science and practice of pharmacy”, the recommended daily intake of Lugol’s 5% solution is between 0.1 and 0.3 ml. Lugol’s 5% contains 125 mg of iodine per ml. Therefore, 0.1 ml has 12.5 mg, and 0.3 ml has 37.5 mg of iodine. The authors point out that today, the recommended daily intake in North American and Western Europe varies between 150 and 300 micrograms per day. That’s a factor of 83 and 125 times less, respectively, two orders of magnitude less.

The study

Based on these studies and observations, the authors move on with their own investigation to determine the amount of iodine needed for breast normality, using an amount of 12.5 mg of iodine in the same form as in Lugol’s solution, providing 5 mg of elemental iodine and 7.5 mg of potassium iodide (KI) in a calibrated, silica-coated tablet to ensure precise dosage, and prevent any possible kind of digestive upsets experienced by some taking Lugol’s solution. (The molecular weights of iodine (I) and potassium (K) are 127 and 39. Therefore, their contribution in KI by weight is 76.5% I and 23.5% K. Hence 7.5 mg of KI contains 5.74 mg of I and 1.76 mg of K, and thus a 12.5 mg tablet contains 10.74 mg of I and 1.76 mg of K.)

Ten caucasian women with normal thyroid volume (< 18 ml), and a range of BMIs statistically representative of the general population based on the NHANES III study (1988-94) in which 25% were overweight, and 25% were obese. Five of the subjects had normal BMI (18.5–24.9), two were overweight (25–29.9), and three were obese (> 30). BMI is defined as the weight in kg divided by the square of the height in meters. So that if you weigh 60 kg and measure 165 cm, your BMI is 60/(1.65*1.65) = 22. Underweight is defined as BMI < 18.5.

An interesting observation about thyroid volume measurements, is that the upper limit for a “normal” thyroid is taken to be 18 ml. These ten women’s average was 7.7 ml (with standard deviation 3.6). That’s almost half. Moreover, looking at national averages in a number of countries, the authors report they are found to be as follows (in increasing order): Sweden – 7.7 ml, Holland – 8.7 ml, Hong Kong – 8.9 ml, Ireland – 12.9 ml, and Germany – 16.5 ml. Not surprisingly, the countries with the highest average volumetric measurements are those with the lowest intake of iodine, and are those with the highest incidence of goitre.

After 90 days of supplementation, the most significant improvements that were noted by the participants were decrease in breast sensitivity or pain, decrease in tremors and in restless leg syndrome. There was no significant effect on blood pressure, body temperature, or body composition except for a small amount of fat loss. From the urinalysis, the only significant difference was that the average pH of the ten participants was 6.05 (+/- 0.69) at the start of the trial, and 7.00 (+/- 0.85) at the end of it. This was attributed by the authors to iodine’s antioxidant properties that would naturally reduce the concentration of reactive oxygen species in the cells, and thereby decrease the acid load on the system, leading to an increase in overall pH that would be manifested by an increase in urinary pH as well.

Blood chemistry was monitored using 17 markers. All stayed within their reference range. But although no significant changes were seen, qualitative improvements were seen in 9 of them (e.g., drop in creatine, drop in calcium, drop in albumin, rise in sodium, rise in carbon dioxide).

TSH (thyroid stimulating hormone) stayed within range for most, except for two participants (#1 and #10) who showed remarkable improvements with a drop from 7.8 to 1.4, and from 21.5 to 11.9 mIU/L. These two participants also showed the most significant change in T4 from 9.2 to 7.9 and 8.3 to 5.4 micrograms/dL, while none of the others saw much change in these values. Free T4 and free T3 stayed more or less the same in everyone. Hypothyroidism is defined as having TSH > 6 mIU/L, and it is estimated that of the order of 8 million American women are hypothyroid, but most of them are unaware of it, what is referred to as subclinical hypothyroid.

Breast pain (mastodynia) significantly decreased in 7 out of the 10 participants, and these improvements persisted for at least 3 months after the end of the supplementation. The authors suggest that the potential mechanisms by which iodine can improve breast health and prevent cancer is by neutralising DNA-damaging reactive oxygen species in the cells, by ensuring proper regulation of the cell’s apoptotic function, and by its ability to trigger differentiation (Derry 2001), therefore stopping or reversing the process by which cells lose their specialised functions as they become cancerous. Obviously, these are crucially important properties of iodine that are independent of thyroid hormones.

Discussion and conclusions

The goal of this pilot study was to evaluate the effect of iodine supplementation in American caucasian women, a population with a high incidence of FDB and breast cancer, with a daily iodine intake comparable to that of women living in Japan with a very low incidence of both FDB and breast cancer. A key aspect of the study was to measure thyroid function and investigate evidence of toxicity. They identify and discuss three potential adverse effects of iodine supplementation: iodism, iodine-induced hyperthyroidism (IIH), and iodine-induced goitre (IIG).

Iodism—an unpleasant brassy/metal taste in the mouth, increased salivation, nausea, and headache in the frontal sinuses—was reported in previous studies on several occasions by people taking 150 mg/day or more. The authors mention that it could have been due to traces of bromine or iodate in the supplements. None of the participants reported signs of iodism in this study.

Iodine-induced hyperthyroidism (IIH)—a condition that occurs in iodine-deficient people in the early stages of iodine supplementation—is described in The Thyroid (8th edition, 2000) by Werner & Ingbar in the following terms: “iodine deficiency increases thyrocite (thyroid cells) proliferation and mutation rates. Possible consequences are the development of autonomous hyper-functioning nodules in the thyroid…and hyperthyroidism. Therefore, IIH is an iodine-deficiency disorder.” None of the participants developed IIH in this study.

Iodine-induced Goitre (IIG) and hypothyroidism—a condition that occurs only under very high doses around 2 g/day (2000 mg/day), and seen in some patients when iodine is used as an expectorant in treating asthma, chronic bronchitis, and emphysema—was not seen in any of the patients of this study. It is noted that people with normal thyroid function taking up to 150 mg/day will see decreases in plasma T3 and T4 concentrations with small compensating increases in TSH but all remaining within normal range. However, in people with thyroid disorders, supplementation can induce IIG, and therefore, supervision through regular blood testing of thyroid markers is important.

It has been obvious for a long time that women need more iodine than men. Evidence of this was seen in Marine’s study in Ohio in the 1920’s, where goitre was 6 times more prevalent in teenage girls than in boys of the same age. Marine also showed that supplementation with the equivalent of 9 mg/d of iodine prevent goitre almost completely, although a few still developed it over the 2.5 year period of the experiment. It has also been known for some time that iodine deficiency leads to abnormalities of the mammary glands.

Studies on female rats by Esquin et al. showed that iodine supplementation was essential to prevent FDB and cancer, and using molecular tracing techniques, also showed that the thyroid preferentially concentrates iodide, whereas breast tissue concentrate iodine. Thrall & Bull (1990) confirmed Sequin’s findings, and in addition, showed that skin cells, as the thyroid, concentrate iodide, whereas the stomach cells, as the mammary glands, concentrate iodine. Therefore, these two forms—iodine and iodide—are not interchangeable as it was believed for a long time, and both forms are needed and essential for healthy physiology.

To establish how much is needed for the breast and thyroid separately, having at this point established that the amount needed for mammary gland sufficiency must be around 12.5–13.8 mg/day, involves establishing the amount of iodine needed for proper thyroid function. For this, the authors refer to the work of Saxena et al. (1962) who define thyroid iodine sufficiency as the minimal daily dose required to decrease the uptake of radioactive iodine by the thyroid to at most 5% of the total radioactive dose administered. The rationale and protective strategy is simple: if there is enough normal iodine to fill the thyroid, its cells will not absorb the radioactive iodine (and it will be excreted); but if there isn’t, it will, and that radioactive iodine, lodged in the cells of the thyroid, will, within days, destroy the gland. Saxena and colleagues established that for an adult this minimal effective daily dose is 3–4 mg.

This implies that the thyroid needs at least this much daily in the form of iodide, and that the breasts therefore need at least around 9 mg daily. But note that this is the amount needed to maintain proper function and health. Correcting deficiencies and overcoming disorders of the thyroid like goitre or hypothyroidism, of the breasts like FDB or cancer, or of the skin like psoriasis or eczema, will require more, sometime a lot more, and usually for extended periods of time.

Moreover, for complete protection of the thyroid against radioactive iodine exposure, Sternthal et al. (1980) showed that further suppression can be achieved using higher doses over at least 12 days: 4% absorption at 10 mg, 1.9% at 15 mg, 1.6% at 30 mg, 1.2% at 50 mg, and 0.6% at 100 mg daily, with no risks at all from the supplementation that remains below the 150 mg/day threshold beyond which some adverse effects can sometimes occur.

Abraham, Flechas and Hakala conclude by stating their intention to expand this pilot study and build a database to develop a protocol for iodine supplementation in FDB and other conditions such as subclinical hypothyroidism.

What is clear from reading this paper is that everyone, but especially girls and women, would benefit from taking more iodine and iodide in amounts of at least 12.5 mg/day. For some this could be lifesaving. And because there are no risks, there are no reasons not to. Furthermore, it was also made clear that much larger doses up to 150 mg/day can be taken, still without risks of adverse reactions, and with the potential benefits of much improved health and powerful healing of very serious conditions such as breast cancer.

We will continue this series with an article by the same three authors entitled Orthoiodosupplementation: Iodine sufficiency of the whole human body.

If you think this article could be useful to others, please ‘Like’ and ‘Share’ it.

Tenderly fragile

A few days ago we had our biweekly science operations meeting. Towards the end of it, one of my colleagues mentioned that the INTEGRAL Picture of the Month for December would be the obituary. “Obituary!?! For whom!?!”, I asked, with surprise and a little anxiety. “You didn’t know? Mike died last week”. It came as a slap in the face. I had no idea he was ill. And obviously, I had no idea he was dying. He was 42.

Mike and I met in Moscow in 2006 at the 6th INTEGRAL Workshop. I had read his papers, and he had read mine, but we had never met. There was a tension between the Russians and the rest of us. The reason is mostly related to the fact that 1) Russian scientists, formally can, and in practice do, work and share data or analysis results only with other Russians; 2) the Russian space agency put INTEGRAL into orbit, and in return, negotiated with ESA to get one quarter, 25%, of the observing time for the lifetime of the mission; and 3) more specifically related to the topic of my own research, the Galactic Centre, the head of the Russian delegation, the great and famous Professor Sunyaev, had negotiated to get half the observing time on this region, and therefore, share all the data half way down the middle with the official Principle Investigator for the Galactic Centre, my PhD co-supervisor, Andrea Goldwurm. So, there were subtle but definitely palpable tensions.

Professor Sunyaev gave a stunning presentation in which he talked about the science that could be and was being done with INTEGRAL data, he drew on his vast mastery of all fields of physics, making analogies, explaining connections, and clarifying issues that most of us could not even see, freshly and spontaneously, without any arrogance, in a simple matter-of-factly kind of way. I was immensely impressed. His was a 40-minute review talk. Mine, on the same day, was a 30-minute presentation, which was also a long one, since the programme contained mostly 20-minute presentations, invited review talks of 40 minutes, and a handful of 30-minute presentations. I gave a shortened version of the talk I had presented in the main amphitheatre of the CEA two months before to my PhD defence committee, and the public in attendance.

Everyone was very impressed, I think because, unlike anything I’ve ever seen at such a scientific conference, the first 10 minutes were spent with my narrating a Discovery Channel video of an voyage through the Galaxy, from the Earth to the Galactic Centre, that I slowed down to give myself enough time to describe the large scale structures and global features of our Galaxy, the distribution of stars and gas that make up its visible contents, talk about their formation and dynamics, about open and globular clusters, types of stars and their different life cycles, about planetary nebulae and supernovae remnants, magnetic field structures betrayed by particles trapped spiralling along them and seen at radio wavelengths, and on and on.

It was during the break after that session that Mike came up to me for the first time. He was bright, quick, sharp as a whistle, energetic and curious, open and friendly, but serious. He had a kind of grave seriousness to him. All these qualities appealed to me. He complimented me on the presentation, and we talked for a few minutes. What struck me most was that he was simple and straight forward: not puffed up, not arrogant, not condescending; and not cautious, hesitant, distant, or reserved either. Just open, simple, and straight forward: nothing hidden, nothing fake. I’m like that too. We connected.

Later that night, we had the banquet dinner, and we spoke a lot more together after eating. Naturally, given that we were in Moscow, everyone (or almost) drank plenty of wine with dinner, and everyone (or almost) was now drinking vodka. Conversations and laughter flowed freely and echoed in the large hall. Mike invited me to come out in the evening, and meet him with other people at a bar where we could watch, while chatting, the football game. It was the time of the 2006 Football World Cup, and this is what defined the plans for the evenings. I agreed, and we spent the evening together.

When it was time to call it a night, after all buses had stopped their service, he offered to walk back with me from the bar to the hotel. I gladly accepted. It was a 45 minute walk across the city, which I didn’t know at all, but which was his beloved home town. So somehow, in those few days in Moscow, we became friends. Friends who didn’t really know much about one another, but friends that connected on a deeper level. These things are hard to explain, and have to do with personal traits and upbringing, tendencies and sensitivities, affinities and outlook. The few other times we saw each other, either at conferences or meetings, it was always the same. We saw each other for a short time,  didn’t really have much to talk about because neither of us liked small talk, but we felt happy to see one another. We exchanged a few Skype chats over the years, but that was the extent of our relationship.

eyewithtear-zoom2

And when I heard that he was dead, I was shocked. What first struck me with sadness is that there was no way for me to express to him how I felt about him, and how sorry I was that he was gone. We often hear of someone’s passing after they have already passed. This makes it impossible for us to express anything to them: no expression of kinship or feelings of empathy, no sentiments of understanding at what they are going through, no words of support, comfort, or warmth. Nothing more can be expressed to them because they are gone. Tears welled up in the eyes. Impossible to say anything. Impossible to write anything. Impossible to reach him. Impossible, now and forever. Feeling sad and helpless, I sat in silence, tender and fragile.

This is what we are: tender and fragile. It’s just that most of the time we don’t realise it, nor do we think about it. When it hits us, and we feel it for a fraction of a second, we push it away, push it down under the shell that we think hides and protects us.

Looking at people every day, friends, colleagues, and strangers, I see so many signs of illness: I see people with the white of their eyes a yellowish colour, with the skin of their face a pale grey; I see dry and dull skin, rashes on the face, or the neck, or the scalp; I see hands and fingers that tremble with uncontrolled tremors when they should be still and unmoving; I see teeth that through a smile can be discerned to be capped by crowns, because they are too white, sitting on top of what are surely devitalised, nerveless, root canal treated teeth, whose dark colour lines the base of the tooth; I see young women with white faces, blueish hued skin under their eyes, sparse and thinning hair, feeling cold and looking down; I see young men with pudgy little man boobs, and men in their 50’s with sparse, balding eyebrows; I see bodies, full of fat, fat that is pressing in, compressing their vital organs, their heart, their liver, their stomach and pancreas. And on, and on. So much disease everywhere, and nothing to be done for these poor people. Nothing to be done because they don’t know, and because they don’t want to know.

Could I have helped Mike? I’m sure I could have. Did he ever share with me anything about his illness? Did he even know I knew anything about health and disease? No, he didn’t. And all these people I see every day? All these people with dehydrated bodies filled with accumulated metabolic wastes, acids and toxins, with undiagnosed intolerances and allergies, with severe B12 and magnesium deficiencies, with bacteraemia from toxic teeth, with serious iron and iodine deficiencies, with testosterone deficiencies and oestrogen overabundances, with extreme insulin resistance and metabolic syndrome, all sick and unaware of it. And what about all those with diabetes and cancer, diagnosed and yet undiagnosed? Is there anything I can do for them, no matter how sad I feel, or how much I would like to? No, there isn’t, because it is they who need to look for it, they who need to want to do something about it. And how can they if they don’t know, or even worse, don’t want to know?

And so, little by little, a little better every day, I learn to live with this. This which we all fundamentally are, whether we allow ourselves to realise it or not, whether we allow ourselves to feel it or not, and whether we want to or not, this is what we are: tender and fragile, tenderly fragile.

If you think this article could be useful to others, please ‘Like’ and ‘Share’ it.

You have cancer, and there’s lots you can do

Everybody knows that cancer rates are rising everywhere and every year. Everybody also knows that the words, “You have cancer. I am sorry.”, fall upon us like a death sentence. Everybody knows this, because we see it all around us, everywhere we look, and we hear about it every day, everywhere we turn.

If a doctor has, indeed, said these words to us, then we are probably scared, probably very scared. We know that basically everyone we have ever heard of who were diagnosed with cancer, died. Sometimes they died really quickly, like, within a few weeks. Sometimes they died within a few months. Sometimes it wasn’t so quick. Maybe it took a year of two, or three, or even five. They went through rounds of chemo. They were on sick leave at home for months on end. They sometimes appeared to recover at some point, maybe a bit, for a little while, but in the end, they died. And they died of cancer.

We also know that not even the most famous and richest people, like Steve Jobs, for example, can escape this kiss of death that the diagnosis of cancer delivers. Wealth and power are irrelevant when it comes to our prognosis as cancer patients: it is always bad. Of course, how bad it is depends on the kind of cancer, but why is it that so many different people, in so many different places, die of cancer every day?

I won’t venture into formulating an answer to this question, and I won’t dwell on cancer survival statistics. I don’t think it’s useful for us right now. I want to hurry and move to the good news. And the good news is that there many things you can do to help your body rid itself of cancer, which is usually the result of a long-standing disease process that has evolved over a lifetime, and has finally manifested itself in this way. This presentation of the question at hand is definitely not exhaustive, nor attempting to be. But this is what I consider to be some of the essential elements.

whitebloodcellsattackingcancercells

White blood cells (shown in blue) attacking cancer cells (shown in red).

 

Understanding cancer

To understand cancer, we have to understand the origin of cancer cells. Cells become cancerous due to a defect in energy production, a mitochondrial dysfunction, an inability to manufacture enough ATP (adenosine triphosphate) through oxidation of glucose or fatty acids to sustain the cell’s functions. This forces the cell to fall back on anaerobic (without oxygen) fermentation of glucose to supplement the deficient energy production from the dysfunctional or reduced number of mitochondria. Fermentation produces an increase in lactic acid in and around the cell. This decreases the availability of oxygen to the mitochondria, which further impedes their ability to produce ATP through oxidation of nutrients, and creates a negative feedback loop that pushes towards further mitochondrial stress and dysfunction, less oxidation, more fermentation, more acid, and less available oxygen.

Because energy production through fermentation is so very inefficient, the cell needs far more glucose, and naturally develops more insulin receptors in order to be ever more sensitive to, and able to capture circulating glucose more effectively. Cancer cells often have 10 times more insulin receptors than healthy cells. What should be clear is that it doesn’t matter where the cancer is, and it doesn’t matter how it evolved, whether it was due to a gradual evolution from an environment too high in glucose, lacking in oxygen, and saturated with acid, or whether it was due to exposure to a toxin or mitochondrial poison, of which there are many and increasingly more in our environment. In the final analysis, this is how cancer cells become how they are, and this is how they survive.

As to their multiplication and proliferation from a single or small group of microscopic cells to large macroscopic tumours in one spot or all over the place, this can be understood by considering that the cell that is devolving from its normal function to that of cell whose only function is to ferment glucose at the fastest possible rate, loses, little by little, the ability to do whatever it was doing before, by losing the ability to produce ATP that can be used by its different specialised parts and constituents to perform their specialised functions, the cell becomes less and less specialised, less and less differentiated and therefore more and more general and more and more primitive, to the point where the essential ability of the cell to destroy itself, when something in its workings has gone wrong, is lost. Having lost this safeguard, the primitive, the undifferentiated, but also necessarily abnormal and weakened cell, just ferments and multiplies, limited only by its ability to fuel itself and sustain this most basic activity of survival without other purpose but this survival in and of itself.

Removing cancer

Having recognised and understood this, the strategy by which we can help the body rid itself of the cancer cells, and regain its healthy physiological functions becomes clear. We have to 1) do all we can to cut off the source of fuel to the cancer cells, 2) clear out the accumulated acids and transform the acidic environment into one that is alkaline and oxygen-rich, 3) help restore the cells’ mechanism of apoptosis—their ability to self-destruct, and 4) do everything else we can to further weaken and destroy cancer cells by means that simultaneously strengthen healthy cells. It’s a simple strategy that is also simple to put into practice, as we will see in a moment.

1) Starve the cancer cells

The first point is to cut off the fuel to the cancer cells. The source of fuel is glucose, because cancer cells can only ferment and cannot oxidise, and the way the glucose is supplied to the cell is by the action of insulin that moves it across the cell membrane. Therefore, what has to be done to is minimise the availability of glucose, and, more important still, minimise the availability of insulin to shuttle the glucose into the cells. The lower the glucose, the less potential fuel there will be. The lower the insulin, the less glucose will actually be able to enter cells. There is no real lower limit. Without ingesting any carbohydrates, the body maintains and regulates blood sugar according to the stress levels and kinds of activities we engage in, independently of how low insulin levels are. And so, the focus should be to have the lowest possible insulin levels naturally.

The fastest way to lower blood sugar, but especially insulin, is to fast, to stop eating altogether, and just drink water and herbal tea, remembering to eat enough salt to match the water intake. The second best way of doing this is in form very similar, but turns out to be much easier to do, is also a kind of water fasting, but with the addition of fat from coconut oil and butter, melted in the herbal teas. Both of these forms of fasting will most effectively deprive the body of anything that can easily be made into glucose, and of anything that will stimulate the secretion of insulin, thereby will allow glucose to drop as low as possible, but more importantly, insulin to drop and stay at an absolute minimum, and therefore most effectively starving cancer cells, no matter where they are in the body and bodily fluids, in the tissues and organs. The first form of the classic water fast is harder, but many people do it without hesitation nor difficulty. The second form is much easier, and may even be more effective in inducing a deep state of ketosis given the additional intake of medium chain fatty acids.

We can easily imagine doing such a fat “fast” for days, or even weeks, depending on the severity of the situation, our resolve to suffocate and starve the cancer cells as quickly as possible, and, of course, the state and circumstances in which we find ourselves. In addition, we can do this as much as possible on any given day, independently of what else we eat. The more fat and the less carbohydrate we ingest, the lower the insulin and the more effective the anti-cancer healing protocol will be.

The third option is to eat and drink to keep insulin levels as low as possible. Here again, because fat is the macronutrient that stimulates the least secretion of insulin, truly minimal, it should be the main source of calories. Simple carbohydrates and starches are most insulinogenic, and protein is about half as insulinogenic as are carbs. Indigestible fibre does not stimulate insulin. Therefore, in the extreme, we would eat only fat, pure fat. The best ones being the most natural and least processed, most saturated and least unsaturated: coconut fat, butter, animal fat and, the best of the vegetable oils, cold pressed olive oil.

It’s important to understand the difference between having low blood sugar, and having low insulin levels. The first is like the amount of food in the kitchens of the restaurant, the second is like the waiter bringing it to the table. It is far, far more important in our efforts to stop the supply to cancer cells that we keep insulin levels as low as possible, than it is to try to keep glucose levels low. And to push the point further, it doesn’t really matter what the amount of glucose actually is, because as long as insulin is low, it will not be brought into the cell, into the cancer cells. The reason I emphasise this is because lack of sleep, emotional or psychological stress, intense physical exercise will all raise blood sugar levels temporarily, in some instances, to high levels. But as long as insulin is as low as it can be, the sugar will not be readily transported into the cells.

Naturally, we cannot have zero insulin, because we would die: our cells would literally starve to death, no matter how much we ate. Babies with a genetic defect that makes their pancreas not able to produce insulin always died of emancipation before the discovery and subsequent commercialisation of insulin as medicine. Similarly, if at any point in a child’s or adult person’s life, insulin stops being produced, incredible weakness and emancipation will follow, before it is tested and identified as the cause of their problem, hopefully in time before permanent damage ensues. Therefore, there is always some insulin in circulation, and therefore, sugar will eventually make its way into at least some cancer cells. This is why it is important to keep it as low as we possibly can naturally, and this is how we can appreciate the essential difference between the effects of high glucose and high insulin.

In a less extreme form than the fat-fast, we maintain low sugar and low insulin by getting and deriving most of our energy from fat. Eating cucumber or celery with almond butter or tahini, for example, or a green leafy salad with lots of olive oil, walnuts, and avocado, provides basically all calories from the fat, given that cucumber, celery and lettuce greens, are basically just water and indigestible fibre, while almond butter and tahini are 80\% fat by calories, and walnuts are 84\%. So is coconut milk, for example, at nearly 90\%, and dark 85\% chocolate, at 84\% fat based on calories. Focusing on feeding the body with these kinds of healthful, high-fat foods, will nourish, stimulate healing, and keep insulin and glucose levels as low as we can without either water fasting, or consuming only fat.

2) Alkalise to remove and excrete accumulated acids

The second point is just as important as the first, because it is the environment in which the cells live that actually has the most direct effect on their function. We have looked at the importance of achieving and maintaining an alkaline environment in the body in several other places. The essence is excellent hydration with alkaline water (pH>8) combined with the intake of proportional amounts of unrefined salt to promote the release of acids from the tissues, and its excretion through the urine by the kidneys. Without proper hydration, the cells will retain the acid with the little water they have to hold on to. Without proper amounts of salt, the kidneys will also retain the acid in order to maintain the concentration gradient that allows the nephron to function when it re-absorbs water.

Naturally, alkaline water will work infinitely more effectively. But the most important detail is the controlled balance between water and salt intake, and what we want is a lot of water and a lot of salt. We cannot take in large amounts of salt water without getting loose stools. So, it has to be smoothly distributed throughout the day, except in the morning, when we get up, because we are dehydrated, and need to drink about 1 litre of water over the course of one to two hours, before we start taking salt.

If you buy mineral or spring water, find the one that has the highest pH value. It should be greater than at least 8. If you have a water filter at home, then add alkalising drops to it before drinking it. I use Dr. Young’s PuripHy drops.

As acidity decreases, and the environment becomes more alkaline, oxygen will flow more freely, and become more available to mitochondria for oxidising fatty acids in producing energy. Remember that cancer cells do not use oxygen, and cannot use fatty acids to fuel themselves, whereas normal, healthy cells, not only can, but function much more efficiently on fat rather than glucose as their primary fuel. Adding chlorophyll and fresh juice of green vegetables to the alkaline water is an excellent way to further boost alkalisation, neutralisation, and elimination of accumulated metabolic acids. Unlike the first step, which is to lower insulin and glucose levels, and that can be done, to a great extent, literally overnight under fasting conditions, alkalising to eliminate accumulated acids is something that takes time. But in both cases, what matters most is consistency. Hour by hour, and day after day, the body will do what it needs to do as best is can, and improve in these functions with time.

Beyond this fundamental necessity to hydrate with alkaline water throughout the day, and day after day, the most therapeutic way to alkalise the tissues, and detoxify the body, is by taking medicinal baths in which we add two cups of sodium bicarbonate (baking soda), and two cups of magnesium chloride (nigari), or magnesium sulphate (epsom salts), if nigari is not available. This is easy, relaxing, extremely medicinal, and very effective in neutralising and eliminating acids and toxins from the body. In fighting cancer, you should be soaking in this kind of hot bath for 45-60 minutes three times per week. The benefits of this ultra simple trans-dermal therapy with sodium bicarbonate and magnesium are incredible. You can read a lot more about this from the baking soda, magnesium and iodine doctor, Dr Sircus.

3) Restore cellular self-destruct function

The third line of action is also essential, and it only requires you to take a few key supplements. The most important of these in the fight agains cancer is iodine, because of its fundamental role both in the structure and architecture of cells, but also in the regulation of apoptosis, the process by which a damaged cell will self-destruct when things have gone wrong somewhere. The importance of iodine cannot be overemphasised. And in healing cancer, or any serious disease condition, we will want to take high doses daily. Doses of at least 50 mg, but preferably 100 mg.

However, because of its very strong detoxification effects, as it pushes out all accumulated toxic halogens out of the cells to replace these by iodine in its proper place, we must work up to these high doses gradually, starting with 12.5 mg, and increasing the dosage as quickly as possible given the body’s response to it. Some people , maybe most, will experience headaches and possible nausea when starting on iodine. This is perfectly normal. The stronger the reaction, the more indicative of the body’s level of toxicity. Therefore, you should always view this as something good, in that toxins are being excreted out of your cells. It is important to support the detoxification process by taking chlorella and spirulina, probiotics and psyllium husks every day as well, while always drinking a lot of alkaline water with added chlorophyll for extra cleansing, if possible.

What I take and consider to be the best supplement is Iodoral by Optimox. Optimox recommends taking the iodine on an empty stomach for faster absorption, but it can also be taken with food for slower and possibly better assimilation. In addition, although iodine can easily be taken on an empty stomach, the co-factors, which include B vitamins, are much better taken with food to avoid potential nausea or queasiness. Moreover, taking it with food will slow down the absorption, and thereby decrease the negative sensations from the detoxification effects. The only thing is that iodine, given its stimulation of thyroid function, will energise the body. Therefore, it should be taken before midday. I take it either first thing in the morning or at lunch (or both).

You can read about the importance and functions of iodine in the following three books: Iodine, Why You Need It, Why You Can’t Live Without It by Dr. Brownstein; What Doctors Fail to Tell You About Iodine and Your Thyroid by Dr. Thompson; and The iodine crisis: what you don’t know about iodine can wreck your life by L. Farrow. There are also many web resources and highly informative forums about iodine and cancer. You can search for the words iodine and cancer to see for yourself.

Other fundamentally important micronutrients are vitamins B12 and D, both of which are needed for proper cellular function, and DNA transcription and replication, because of their roles in the nucleus of cells, activating and de-activating, switching on and off genes, to ensure everything in the cell works as it should. For best and fastest results—and that’s definitely what we need in our fighting cancer—B12 should be injected weekly in the amount of 1 mg, and in the form of methylcobalamin. (For optimal health in normal circumstances, it can be injected once a month in the amount of 5 mg.) Vitamin D should be taken with its sister vitamins, A and K2, for synergistic effects and biochemical balance in their functions. Each of these have complimentary roles, and should generally be taken together, unless there is a reason not to. You can read these two articles published by Chris Masterjohn from the Weston A. Price Foundation to learn why and how: On the trail of the elusive X-factor: a sixty two year old mystery finally solved, and Update on vitamins A and D.

It is by supporting proper cellular function, especially in the nucleus, with iodine, B12 and D, that cells will regain, little by little, the ability to recognise that they are damaged and need to self-destruct. There will always be millions or even billions of cells involved in the disease process we call cancer, but they will be distributed along a wide spectrum of dysfunction, from having very mildly impaired mitochondrial function from a light oxygen deficit cause by a little too much acid in the environment surrounding the cell, to full cancer cells that derive 100% of their energy needs from anaerobic fermentation without using any oxygen at all, and thriving in extremely acidic conditions.

Hence, many cells will die from being starved of glucose, because that’s the only fuel they can use; many cells will recover enough of their normal regulatory mechanisms to know its time to self-destruct; and many cells will actually regain their healthy function, repair their damaged parts, and replace their dysfunctional mitochondria with new ones. Nothing is ever black and white when it comes to cells and cellular function. Instead, everything is grey. But it is a million different shades of grey.

4) Do everything else that can help

The fact is that there are many, many more things you can do. Many therapies, many treatments, many supplements and herbal formulas, that have all proved highly effective against cancer. There are so many that many books have been written about them: About Raymond Rife, you can read The Cancer Cure That Worked by Barry Lynes; about Gaston Naessens, you can read The Persecution and Trial of Gaston Naessens: The True Story of the Efforts to Suppress an Alternative Treatment for Cancer, AIDS, and Other Immunologically Based Diseases by Christopher Bird; about Rene Caisse and the Essiac tonic, you can read Essiac: The Secrets of Rene Caisse’s Herbal Pharmacy; about Johanna Budwig, you can read Cancer – The Problem and the Solution; and the list goes on. There are websites devoted to these people and their approach to cancer, and this is just a few of them that I know about. One book that compiles a lot, maybe most, of the information on non-toxic treatments for cancer, is Ty Bollinger’s Cancer: Step Outside the Box.

Maybe you find it hard to believe that our governmental and medical authorities would have gone—and continue to this day—to go through such extreme measures in order to suppress treatments that work so effectively to help and heal people of their illnesses and of cancer, without negative side effects, and at very low costs. But this is a simple fact. And it is quite easy to understand if we consider that anyone, or any institution, that has commercial investments and interests in a particular endeavour, will go to great lengths to maintain and strengthen, as much as they can and for as long as they can, the conditions that make them successful. There’s nothing more to it than that. Let’s look at a few of those therapies and supplements which are easy to implement, and highly effective against cancer: hyperthermia, flax seed oil, enzymes, and turmeric.

Hyperthermia, or heat therapy, is a very well studied and effective therapy against cancer, both preventatively and curatively. The idea or principle is very simple: healthy cells can withstand high temperatures without damage. The reason why this is so, and why we know it for sure, is that the body produces fevers as a defence mechanism to destroy invading viruses and bacteria that, unlike our own cells, cannot withstand the heat. Similarly, cancer, and other compromised and damaged cells, are unable to cope with high heat. Hence, it was hypothesised, tested, verified and demonstrated that hyperthermia is really very effective at destroying cancer, while simultaneously cleansing and strengthening healthy cells and tissues. Infrared saunas are ideal in heating the tissues more deeply, but any sauna, steam room, or even bath that induces hyperthermia by raising the temperature in the body, will help kill cancer cells, cleanse, and restore health.

Enzyme therapy has also been used for many decades in the treatment of cancer patients extremely successfully. The late Nicolas Gonzalez who passed away last year, was its most recent champion, following in the footsteps of his mentor, Dr William Kelley. The treatment protocols are more complicated, and are always highly individualised, but the main element is the supplementation with large doses of enzymes, combined with the colon cleansing to eliminate the dead tumour tissues from the body. Large quantities of fresh vegetable juice are also often included in his recommendations. You can read about it here: http://www.dr-gonzalez.com/index.htm, but whether you decide to throw yourself completely into it or not, I strongly recommend taking proteolytic enzymes three times per day, always on an empty stomach at least 30 minutes before eating, and support cleansing by taking a colon cleanser before going to bed. This site, http://www.losethebackpain.com, has good quality enzymes and cleansing supplements that we’ve used, but you can also do your own research.

Flax seed oil, organic and cold pressed, combined with fresh organic quark or cottage cheese is, based on Johanna Budwig’s extensive, lifelong research, as well as practical clinical experience with patients, is another one of the most effective and simple cancer treatments. And although the biochemistry of it, and biochemical pathways through which the cancer is weakened and destroyed may be complicated, the implementation is very easy and simple, costs very little, and cannot in any way bring about harm, unless one is severely allergic to milk proteins (in which case the dairy can be replaced with another source of protein that will work as the carrier). Here is a good article that has links to other excellent articles about this: https://www.cancertutor.com/make_budwig/

Turmeric, an ancient, bright yellow, Indian spice, which is a powder made from drying the ginger-like root that is turmeric, is one of the most researched natural substances in modern times, and is surely one of the most powerful natural anti-cancer supplements. Since it has tons of wide-ranging health benefits, and carries no risks at all, it’s clear that everyone can benefit from it. You can read about it from Mercola here. You should take it three times per day, but with your meals, because the more fat there is in the gut, the better the absorption will be, as is true for most antioxidants, vitamins, and minerals.

I feel it is important to emphasise the point just made about the risk-free nature of supplementing with turmeric, because it is a crucial point that applies to everything we have discussed here, and everything we have discussed in all the natural healing protocols and nutritional approaches we have presented in the past. Food-based nutritional healing is, in general, risk-free, because it doesn’t involve ingestion of or exposure to toxic substances, and instead involves correcting deficiencies, boosting nutritional status, and optimising the biochemical and hormonal environment of the body in order to promote healing.

Of course, we can object by referring to examples of people dying from drinking too much water too quickly. But we are not talking about such extremes. Nonetheless, we could, for example, eat coconut oil or butter all day, and other than the possible nausea from taking in so much fat, you wouldn’t get anything more than loose stools. Moreover, the body’s own hormonal responses would naturally prevent overconsumption through a feeling of extreme satiety that would basically make it impossible to willingly eat more.

Another example is that of using baking soda or iodine. So simple, and yet so powerful, they stand as the perfect examples of the benign nature but extreme effectiveness of natural healing. We find written in the most recent edition of the Manual for the Medical Management of Radiological Casualties of the US Military Medical Operations, Armed Forces Radiobiology Research Institute, that sodium bicarbonate will “prevent deposition of uranium carbonate complexes in the renal tubules”, and that we should, “within 4 hours of exposure, administer potassium iodide (KI) to block uptake of radioactive iodine by the thyroid”, because they are the best known ways to protect the kidneys and thyroid from being destroyed by the radioactive elements that would—without the use of sodium bicarbonate and potassium iodide—migrate to these organs and destroy them.

But why wait for a chemical spill or a nuclear power station meltdown in order to rid the body of accumulated chemicals and toxins, and to replenish every cell with a plentiful supply of iodine to ensure that all cells and all glands function at their best, now and every day? We don’t have to wait. The same goes for turmeric, for enzymes, for B12, for A-D-K2, for hydration, for alkalisation, for minimal glucose and minimal insulin loads, for maximum nutrition and maximum health. Why don’t we start doing this preventatively right now?

Summary and Wrap up

Maybe you know all of this stuff already, or maybe you don’t and you are blown away and overwhelmed by the amount of information and range of topics we have covered. Maybe you are reading this because you are interested and curious to learn and be as well-informed as you can about health topics, or maybe you are desperately looking for relevant information that can help you or a loved one. No matter in which camp you find yourself, here is the summary and wrap up I can offer to bring all of what we have discussed down to a simple set of recommendations that anyone faced with a diagnosis of cancer, and fearful of, or skeptical about, or doubtful that the current standard of care in the cancer industry will help them, can understand and follow, knowing that none of these food choices, supplements, and therapies will bring them harm in any way, and that all will only do good, regardless how dire or hopeless their situation may appear to be.

  • Keep low insulin levels, as low as possible, by not having insulin-stimulating carbohydrates, and by keeping protein intake reasonably low. Focus on consuming natural, unprocessed fats as much as possible to supply the largest proportion of your daily calories. Consider a water or a tea-with-fat fast for a few days when it is suitable, or even as an intermittent fasting strategy on a daily basis. Consider also doing a green juice “fast” (only green vegetables) with added fat from blending in melted coconut oil or milk.
  • Drink alkaline water, always on an empty stomach, considering the day as divided between hydration periods, and feeding and digestion periods. The first hydration period is from the time you get up until you have your first meal. It is good to extend that period if you can to allow plenty of time for proper hydration after a long night of dehydration, with at least 1 to 1.5 litres over a period of at least 2 hours. Drink slowly to improve absorption and not pee everything out. Always allow 30 minutes without drinking before meals, and 2-3 hours after meals, depending on their size. The cycles of hydration and feeding during the day (for 3 meals) should be as follows: drink, wait, eat, wait, drink, wait, eat, wait, drink, wait, eat. For only two meals, which I recommend, then periods of drinking are extended and allow for even better hydration, cleaning of the blood, and better digestion.
  • Take iodine supplements with the co-factors and with food to maximise absorption and effectiveness. Start with 12.5 mg per day, and work your way up to 100 mg. Do this as quickly as your body allows you to. Take the iodine every weekday, and stop on weekends; five days on, two days off. (My wife and I take 50 mg per day.)
  • Take hot baths with sodium bicarbonate and magnesium chloride (or sulphate; 2 cups of each). Soak for 40 to 60 minutes. Do this three times per week. Always take your baths on an empty stomach, and drink at least one litre of alkaline water during the length of the bath. (Once per week is what I aim for as preventative medicine.)
  • Get B12 injections of methylcobalamin, 1 mg on a weekly basis. (My wife and I get a 5 mg injection once per month.)
  • Take proteolytic enzymes and Essiac tonic three times per day, always on an empty stomach, always at least 30 minutes before meals. (We take it once, first thing in the morning.)
  • Take turmeric and turmeric extract, as well as A-D-K2 with every meal or fatty snack, three times per day during recovery. (Once daily in normal circumstances.)
  • Take infrared or regular saunas, every day if possible, or even in the morning and at night if you have or decide to buy your own little sauna. I would definitely do this given how effective hyperthermia is at destroying cancer cells.
  • Eat Budwig cream.
  • Eat and drink greens.
  • Spend time outdoors, as much time as you can, moving, breathing fresh air, exposing your skin to the sunlight.
  • Keep low stress levels, as low as possible. Take tulsi, ashwagandha, and HTP-5 to keep stress hormone levels low, and mood high.
  • Take probiotics, chlorella and spirulina in the morning, and a colon cleansing supplement before bed.
  • Sleep well, long restful nights. Melatonin is very useful for this, and has many additional health benefits.

Cancer is very easy to prevent, but somewhat harder to dislodge once it has taken hold somewhere within the body. But no matter what type of cancer, how localised or generalised it is, or at what stage it finds itself, there is always hope. Hope of getting better and more comfortable, and hope for a complete recovery.

We have to remember that cancer cells are degenerate and weak. By making the environment as health-promoting to normally functioning cells, and simultaneously as hostile as possible to cancer cells, they will perish and be cleared out from the body as the waste that they are. The body heals itself, often miraculously quickly, when impediments are removed, and the elements needed for healing are provided. With all my heart, I hope this can help you and your loved ones.

If you think this article could be useful to others, please ‘Like’ and ‘Share’ it.

Keto-adaptation for optimal physical performance

A young man I know recently started to play rugby at a higher level, and thus more seriously than he ever has in the past. Being a smart guy, he wants to get his nutrition “on point”, as he writes, in order to perform at his best. He started reading about nutrition on the internet, and found it to be like “a snake oil convention”, which it most certainly is. So, he contacted me to get my opinion on the subject. I’ve been meaning to start writing about training and performance for a while, and balance out all my writings about disease and overcoming disease conditions, and so I thought this would be the perfect opportunity to start.

The first thing that needs to be said is that there are common aspects as well as differences in the way training and nutrition should be optimised for different disciplines and goals. In common to all disciplines, are that we always want to perform at our best, and recover as fast as possible. Those are the basic and most fundamental drivers.

Differences are much greater in number and far wider ranging in kind, but they can include core aspects like the duration of the event: speed and power versus endurance and stamina (think of the 100 meter dash versus the marathon, or the velodrome cyclist versus the Tour de France rider); the kind of effort required: sustained versus bursty (think of rowing versus tennis); the medium and nature of the forces against which we are working: water or air, with an intervening machine or without (think of swimming versus jumping towards the rim to slam dunk the basketball, skying versus bobsledding, wrestling or judo versus Formula 1 racing).

In every case, there are preferred and optimal skills and trained reactions, fitness and body composition, as well as morphology and muscular development. For now, let’s just look at the basics in the sense of what every athlete would want and would benefit from no matter what kind of activity they do: best performance and fastest recovery.

The most fundamental point is mitochondrial energy production

At the root of all activity of the body, and at all levels, is the generation of ATP by mitochondria. This is really the bottom line for everything, because this is what cells use to function and do what is required of them in every instant. Mitochondria, small organelles thought to have migrated into a cellular membrane early in the history of evolution of life on the planet, are present in every cell in different amounts, and are essential for life. They can oxidise or burn any macronutrient—glucose, amino acids, or fat—to produce ATP, but the bulk is derived either from glucose or fat. In the process, they produce byproducts of different kinds and in different amounts based on the nature of macronutrient used for fuel, and on the energy demands. Therefore, for optimal performance with a fixed number of mitochondria, we want:

  1. the maximum efficiency in ATP energy production, and
  2. the minimum amount of metabolically taxing byproducts.

These question of deriving the most amount of ATP in the most efficient way with the least amount of byproducts that ultimately impede physiological function, has been considered in On the origin of cancer cells (1 and 2)To summarise in very few words: fatty acids are the most efficient way to store energy, on a gram-per-gram basis they produce the most ATP when oxidised by the mitochondria in an oxygen-rich environment, and their oxidation result in the least amount of acidic and physiologically costly byproducts. Therefore, the inevitable and obvious conclusion, is that for optimal physical performance, we want maximum metabolic efficiency, and for maximum metabolic efficiency, we need to provide the conditions that allow our cells to use fatty acids as their primary source of fuel.

The key is efficient fat utilisation

Efficient fat utilisation is achieved in three stages, which are really just two, because the second and third blend into one another seamlessly. The first step is making sure cells can use fat as fuel. Because insulin signals cells to store energy, it prevents fat utilisation (lipolysis). Inhibiting lipolysis is one of insulin’s main functions. To allow cells to burn fat, insulin must be low. To lower insulin levels, we must either fast, or restrict carbohydrates (and to a lesser extent protein). In fasting conditions, most people will reach insulin levels low enough to start fat-burning after 12 to 16 hours. With severe carbohydrate and protein restriction, that means getting all or almost all of your calories from fat, the timescale is probably similar.This first step is therefore achieved within 24 to 48 hours.

The second step is basic adaptation to deriving cellular energy needs from fatty acids, those that we eat, and those that are stored within the body’s fat cells (adipocytes). This is achieved over the course of about 4 weeks by maintaining a very low carbohydrate, low to moderate protein, and high fat diet.

The third and last step is full keto-adaptation, achieved within two to four months of consistent carbohydrate restriction. The word keto in the term keto-adaptation refers to the fact that, from the breakdown of fats, the liver manufactures ketones, the one we measure as a marker is usually beta-hydroxybutyrate, used primarily to fuel brain cells that can only use glucose and ketones. This stands in contrast to most other cells that can use fatty acids directly. An exception to this—the only one, as far as I know—are red blood cells that can only use glucose.

A point that needs to be appreciated relates to the potency of insulin to stop fat-burning. As soon as glucose spikes, insulin will spike, and will stop fat-burning. This is particularly important if we are aiming to burn as much fat as possible or become as efficient fat-burners as possible. Consequently, the very worst thing we can do is to have sugar in the morning, just before or just after training. Even a small piece of fruit will do it. This will generally always stop fat burning in its tracks. And not just for a few minutes, but for hours, all the hours necessary for insulin levels to drop back down low enough to allow lipolysis to start again.

Maximally efficient fat utilisation is where an athlete wants to be, because this will ensure that they always use as much fat and as little glucose as possible, maximising endurance potential while minimising production and accumulation of lactic acid in the muscles. The most important benefits this brings are to be able to sustain long hours of exercise without “hitting a wall” from the exhaustion of glycogen stores, and having muscle fibres that can function smoothly unimpeded by the presence of large amounts of lactic acid, something which also significantly accelerates recovery, as very little time is needed to clear out the small amounts that remain in the muscle after the event or training session.

Fat stores are, for practical purposes, inexhaustible. Even in very lean athletes (below 10% body fat), there will be between 5 and 10 kg of fat reserves to draw on during that ironman, that ultra-marathon, or that mountain-bike-around-the-clock event. Each gram of these 5-10 kg provides 9 kcal of fuel. And so, that endurance event lasting 12 hours during which you burn 7500 kcal could be fuelled with just 830 g of body fat. Naturally, this would not happen, because glycogen from the liver and the muscles will always be used in greater or lesser amounts depending on the level of stress (physiological and psychological), and intensity of the exercise. Nonetheless, this is a good illustration of the massive reservoir of fuel we have at our disposal if we train the body to utilise fat efficiently.

montBlanc-ultraMarathon

The Mont Blanc ultra-marathon. All long distance runners should be keto-adapted.

To get to this point, the muscle cells need to be trained to use fat, first at very low intensity to make sure that they can fuel the activity using mostly fat, and then gradually increasing the level of intensity to force adaptation in continuing to burn fat as the primary fuel. Best way to achieved this, is by doing low intensity endurance work in a fasted state. And over time, gradually extending duration and increasing intensity.

Moreover, doing intense, muscularly demanding, resistance training in the fasted state, is beneficial in many additional ways, including the secretion of greater amounts of growth hormone and testosterone for better growth and repair of tissues, as well as more effective fat utilisation, and protein recycling, which involves the breakdown of damaged, scarred, and otherwise unused tissues in order to maintain, feed and rebuild the muscle tissues that are being used. The same mechanisms involved in protein recycling, act to preserve muscles that are active, while facilitating the breakdown of other tissues, and in particular fat stores, that are not.

There are many benefits to training in a fasted state, and doing both low intensity endurance, as well as high intensity resistance training. This is especially true over the long term, as the body becomes increasingly more efficient at fat utilisation, increasingly better at preserving active muscle mass, and increasingly more effective in repairing damaged tissues and cleaning out metabolic wastes. Such conditions are naturally highly favourable for building strong, healthy, lean muscle mass.

Fast recovery requires minimising inflammation

Whenever we do anything physical, some level of micro tears, fractures, and injuries to the muscle and bone tissues take place. The body’s repair mechanisms involve an inflammatory response. Without a healthy inflammatory response, we would not be able to recover from injuries, recover from training, or build bone or muscle mass. In fact, we would not be able to survive. What we want, is a fast and effective inflammatory response to heal, repair, or build whatever needs fixing as quickly as possible. What we do not want is a low-level of chronic inflammation that cripples the body from functioning at its best.

One of the greatest advantages of running on a fat-based metabolism with maximally efficient fat utilisation, is the fact that the muscle cells are fuelled by burning fatty acids without producing lactic acid. This is in stark contrast to a glucose-based metabolism, where most of the energy is derived from burning glucose, and this always produces lactic acid. As intensity increases, the amount of lactic acid produced will depend first on the intensity, and second on the level of keto-adaptation. The better the keto-adaptation, the more fat will be used to fuel the cells at higher levels of intensity. But, no matter what, the keto-adapted individual, and the athlete in particular, will always, and in all circumstances, produce less lactic acid than the one running a glucose-fuelled metabolism.

All acidic metabolic waste products need to be eliminated from the body. This is the role of the kidneys, whose function we have explored in The kidney: evolutionary marvel. For lactic acid that accumulates in the muscles, the first stage is to get it out of the muscle, and this usually takes quite a while. It can take from hours up to several days. The process of clearing it out can be accelerated using massage, stretching, and very low intensity exercise. Alkalising baths are a fantastic therapy for accelerating recovery, and lowering inflammation. Magnesium chloride and sodium bicarbonate baths are therefore an absolute must for the serious athlete. We have detailed the importance, roles and functions of magnesium in Why you should start taking magnesium today, and discussed inflammation and the importance of alkalisation in Treating arthritis (1 and 2). 

In the end, all metabolic acids lead to increased inflammation, and, when they accumulate in joints and tendons, inevitably to injury. Insulin-stimulating carbohydrates also cause inflammation. They trigger hundreds of inflammatory pathways. And so, by eliminating them from our diet, and allowing the metabolism to run on fat, we have done as much as we could ever do with our food to minimise inflammation in the body. This is what an athlete wants for the fastest possible recovery time, with best training performance, and the smallest risk of injury.

The final and most important element for fast recovery and low inflammation is optimal hydration. This is the most important because all of the body’s cleaning mechanisms, and especially the function of the kidneys, depend intimately on water and salt. Drink alkaline water on an empty stomach—at least 3.5 litres per day. Eat plenty of salt with all your food—at least a full teaspoon. The more you sweat, the more water, and the more salt you need. We looked in detail at how much of each is optimal in How much salt, how much water, and our amazing kidneys.

When do we eat?

If we train in a fasted state, the best is to train in the first part of the day, taking advantage of the fact that the fast has already lasted 12 hours or so. We can rather easily extend that further, and train around noon, following about 16 hours of fasting. Either way, we will want to eat between one to two hours after training, allowing a good amount of time to make sure the body is well hydrated, and stress levels have dropped. This will bring us to having our first meal of the day somewhere between 12:00 and 15:00. Different people have different schedules and preferences depending on the rhythm of their work and personal life. There are no hard rules, and things have to remain flexible, as irregularity is also an important part of training the body to be more adaptable. In fact, you should be somewhat irregular with your schedule for just this reason.

We can have only one meal per day, or we can have two, or we can have one big meal and some snacks, or, best of all, we can sometimes have one meal, sometimes two meals, sometimes have snacks, and sometimes not. The main point in training the body for optimal metabolic efficiency, is to be a significant amount of time, somewhere between 12 and 20 hours, without eating, and to train in a fasted state, in conditions of low blood sugar and low insulin levels. We discussed intermittent fasting in The crux of intermittent fasting, concluding that one of the most important points for successful and effective intermittent fasting is that the body be fuelled by fat and not by glucose. As you will have gathered by this point, our context here relies on the fact that the body is keto-adapted, and therefore, fuelled by fat.

What do we eat?

That was the original question my friend wanted answered, and it is, in a way, very simple to answer: we eat only the least contaminated, least processed, and least insulinogenic, the most natural, most nutrient dense, and most digestible.

Least contaminated means minimising our body’s exposure to toxic substances, heavy metals, hormone disruptors, pesticides, herbicides, chemical additives, anything that is toxic in one way or another. Least processed means minimising manufactured foods, of which we don’t need any. Least insulinogenic means minimising foods that stimulate the secretion of insulin from the pancreas, and this means minimising intake of simple sugars and starches, and not over-eating protein which is about half as insulinogenic as carbohydrates.

Most natural echoes least contaminated and least processed, but additionally implies a freshness, a wholesomeness, an absence of adulterations and manipulations. That’s what we want. Most nutrient dense means maximising mineral content, vitamin content, optimising amino and fatty acid profiles, and overall micronutrient content for a given amount of calories. Most digestible means minimising digestive stress, maximising enzyme content and nutrient absorption.

Digestion, the function and health of the digestive system, is essential. Everything from the food we eat is made available and usable—or not—by and through the digestive system. We have written about digestion on many occasions, but most specifically in Understanding digestion, Intensive natural healing, and Why we should drink water before meals.

But in practice, what do we eat? No junk of any kind. No polyunsaturated oils. No sweet things. No starches. Excellent animal foods and excellent plant-based foods: grass-fed, full-fat meats and organ meats like liver; nutrient dense and non-toxic fish like sardines, herring, anchovies, seafood and wild fish (avoid tuna, swordfish and any other large predatory fish, because they contain large amounts of mercury and other heavy metals); fatty nuts and seeds, especially coconut products, but also walnuts, macadamia, almonds, hazelnuts; dark leafy greens, both in salads (mixed baby greens, baby spinach, arugula, lamb’s lettuce, lettuces of all kinds) and steamed (chard, spinach, and anything similar); green vegetables like celery, cucumbers, broccoli, asparagus, and string beens; colourful vegetables like purple cabbage, red and yellow peppers. You can eat pretty much anything you can think of that is not processed, nutrient poor, or highly insulinogenic.

What should you have for breakfast? We already solved that problem! You do not eat breakfast anymore, remember?

What do you have for lunch after training? You’re in a rush or just lazy? Well, make yourself a coconut milk smoothy. You can put some protein powder (whey or plant-based, but never soy!), some superfood powders, some hemp or chia seeds. You prefer it sweet-tasting? Put some raspberries or blueberries, and stevia extract. You prefer it green and salty? Put some spinach and salt. In both cases, you can add avocado whenever you want. You can make it with cacao powder, with vanilla extract, or with almond extract. You can add raw or roasted almond or hazelnut butter, sunflower seed butter or tahini. Anything you want that is wholesome and healthful. You’ll need to experiment to find combinations you like. Start simple with few ingredients, and add things bit by bit to keep on top of the process and the blends of flavours.

If you’re not in a rush, or don’t want to have a smoothie? In this case you eat exactly as described above: healthy, nutrient dense animal and plant-based foods. This can be as simple as a can of sardines with a bag of organic baby greens. And for supper, the same as for lunch, really. The same simple and basic principles apply to everything you eat at all times, with these two additional points to keep in mind:

The first is that because we do not eat for a significant part of the day, and also because we eat either just one or two meals, it is crucial to get enough calories and fat, nutrition and protein. Otherwise, we will quickly find ourselves in calorie deficit, and this means that if we keep it up for a long time, we will first burn through our fat reserves, and then burn through our muscles. As athletes, we definitely do not want this. So, it is very important to get all the calories we need, especially if we train a hard or long hours on a daily basis.

The second is that for good, deep and comfortable, restful and restorative sleep, we shouldn’t go to bed on a full stomach, and most importantly, not on a stomach full of protein. Digestion is energy intensive. In the case of protein, it is also highly thermogenic, which means that it generates heat. Therefore, going to bed after a large protein meal will  lead to a restless, tossing, turning, hot and uncomfortable sleep. For a deep and restful sleep, we want the opposite: little digestive activity, a slow heartbeat, and a low body temperature. This means that large protein meals should be had several hours before bedtime, in the afternoon or early evening, allowing a good three to five hours for full digestion before going to bed. If you can’t avoid eating late at night, then eat light: a salad is perfect. For a snack instead of a light meal, have a couple of tablespoons of almond butter on cucumber slices or with celery sticks, for example. Because sleep is really the most important part of the body’s recovery process, it is imperative to optimise sleep.

Closing thoughts

With all of what we have discussed mind, is it really any surprise that more and more professional athletes are opting for this metabolic advantage? A number of years ago, the tennis champion Novak Djokovic divulged one of his secrets. What was it? It was exactly this. This year, the third time winner of the Tour de France, Chris Froome, also divulged one of his secrets. What was it? It was exactly this. Are you curious, say, about Froome’s standard first meal of the day? Four poached eggs, smoked Alaskan salmon, and steamed spinach. Surprising breakfast? Not in the least. Indeed, an excellent breakfast!

We are seeing more and more runners, swimmers, triathletes, but also power lifters and body builders making the switch. It is to their advantage, and when they themselves feel the difference it makes, they know it to be true, at which point there is no turning back. Obviously! Who in their right mind would give up such a metabolic advantage? I suspect that eventually, this will be the standard.

And it’s not surprising at athletes from various disciplines have made these changes to their diets and lifestyles. What is surprising is that so few have actually done this. The change is low, but there is a clear shift in this direction. This is attested by witnessing training specialists promoting these principles, training athletes in this way, and demonstrating the immense advantages that it brings to them in their performances. Vespa Power discussing fat utilisation on their website is a good example.

Is all this stuff new? Of course not! Medical doctors, nutrition researchers , diabetes and metabolic medicine specialists have been talking about this for many decades. Some pioneers include Atkins, Rosedale, Volek and Phinney. And the tradition has continued and expanded, especially in the last decade.

Is this the whole story? Of course not! It never is. But it covers the basics. I plan to explore different aspects of what we started discussing here. You can read more about all these things on blogs and websites. Here are three I have read: the athletic MD Peter Attia had a good blog with many informative articles (especially in the beginning) about physical performance at different stages of his own keto adaptation process. The professional ironman triathlete Ben Greenfield also has written about his experience going form fuelling his body with glucose to using fat instead. I point to these because they have articles specifically about the process of keto adaptation we describe above as foundational for optimal sports performance, and also because they were both meticulous in quantifying the physiological changes and writing about them.

Marty Kendall has a very good blog on optimising nutrition in the sense that we have discussed here, and have been writing about for five years, starting with our very first post, What to eat: four basic rules. But what Marty has done is to actually quantify the value of foods, using the USDA nutritional database, assigning to each food an insulin index derived from its insulinogenic potential, and a nutrient density score based on its macro and micro nutrient content. The associated Facebook group is a great resource for information on this and related topics.

Now that we’ve reached the end, I hope this was useful, and that I have managed to show that, whatever the reason or motivation, whatever the sport or skill set required, there is really no other option other than this when you are serious about optimal physical performance.

If you think this article could be useful to others, please ‘Like’ and ‘Share’ it.

Lauri’s amazing story

This is guest post by Lauri.

It was a sunny day, not long ago. The phone rang. I did not recognize the caller. I answered. It was an endocrinologist calling about my test results. After relating them to me, he asked: “are you really not taking any drugs?” I said: “no, I’m not”. After this he asked specifically about each of the tests, and about the drugs usually prescribed to address the problems to which they are related, all of which I had. He asked over and over again: “are you sure you didn’t take this drug?” Each time, I gave him the same answer: “yes, I am sure. I didn’t take any drugs”. He had no choice but to give up. He gave a little laugh, and said: “well done!”.

As I was hanging up the phone, I realised that this time I had forgotten that the doctor was going to call me. Not  long ago, it was a very different scenario: each time I went to see a doctor, or was waiting for their call with the results, I felt like an animal in a cage, trapped, unable to run, just waiting for more bad news.

In that moment I felt the warmth of the sun on my face. And I felt good. I felt that life was good, that it was smiling at me. In that moment, there was no ill sensation, no aches, no feelings of discomfort, no signs of disease. How had I gotten here? How was I just a few years ago? Let’s take a look back and see.

As a kid, I had major issues with vomiting. But they went away when I reached the teenage years. Other than that I was generally pretty well. The “normal” yearly flu, little problems here and there, but who doesn’t? Life was pretty great. As a late teen, I enjoyed drinking and smoking as much as the next guy, but nothing excessive. 10 years later, I was smart enough to stop smoking. I thought I was living a very healthy life since then. Boy was I wrong…

I started to have troubles with my stomach. I was given drugs. And as they were prescribed, I remember being happy. I can now take drugs for free and all would be fixed. The problems did not go away. They were just starting. I started having headaches. I started having troubles with my eyes. They were drying up so fast that I felt I needed to use drops multiple times per day. I was stressed out all the time with no apparent reason. For the most part of the day, I had a very strange sensation, one that people usually describe as low blood sugar. Feeling of the floor under me would move, loss of balance and the sensation that someone would have screwed a giant clamp over my head. This only went away when waking up and going to sleep. I always thought that eating would make me feel better. But I never felt better. Time went on, and I just got used to it.

I was 27. Never had any problems with my heart, until one day, I woke up with a strange feeling. Something was not right: I was having fibrillations. Later that evening I was waiting for an electrical cardioversion. In the ER I had some time to think when they were hooking up the monitoring systems. To thought to myself: I should be at the peak of my life, and here am hooked up to a bunch of machines with heart palpitations. The diagnosis, after all the tests and examinations, was sarcoidose in the lungs, and most probably in other places as well.

It is after this event that the problems really started. I felt cold all the time, no matter what. I had never felt cold before, ever. I started to have such chest pains that I could not put a hockey stick to the ice, the shock went all the way through from the stick to the chest. I tried to lower myself at the level of my knees, and as soon as I did that, palpitations would start and continue for as long as I stayed bent over. I learned to sleep on my back since turning to one side would cause the heartbeat to go haywire, every time, and instantaneously.

The sarcoidose was causing hypercalcemia, hypothyroidism and hypogonadism. The entire hormonal system started failing. Almost all pituitary-controlled hormones going down, and as a man, anyone who has had almost zero testosterone knows what that feels like. Nearing 28, here I was. At the age I should have been at my peak, feeling like I could take on the world, I felt like a weak and crippled 90 year-old.

Sometime in the middle of this, I found Guillaume’s blog. I hadn’t read any blogs. I used to think they were just about people telling what they wore to work that day. I really was not in a place where I would stop listening to my doctors to follow a regime I found on some random blog somewhere online. I started to read it anyway. I remember I was searching for information on when to take psyllium husks. I read the article about that, and thought it was written in a special manner. I took the advice, and a few days later, read another article. That really was the turning point.

Written in such a way that somehow left me no choice but to read them all. When I was done, I thought back on the whole thing, and realized I did not remember anything. So, I read them again. After the second pass, I knew i was doing exactly the opposite all of the things mentioned. Then I started to break it down to little pieces. I took one article that I thought I could follow, and started following that. At the start, I was sure I could never live a life that fully implemented all of the recommendations. I remember thinking, it must be impossible to live like that.

But something in my mindset had changed. I noticed myself going back, rereading another article, and starting to follow that. A year later, I had implemented almost half of the changes. And a year after that, I was doing it all.

Our different lives, situations, places where we live, climate, wealth, all play a part on how we implement these teachings. But I think I understood the most important part. There is not one without the other. So that time I knew I had to do it all.

From the very start, Guillaume had the utmost confidence I would heal. And never during this process I felt like he would throw in the towel. On the contrary, I got regular updates and additional inputs based on my progress, and most importantly, an unwavering confidence and support.

After some months, I started to see something. I had a growing number of warts on my feet. And I mean had so much of them that there were almost no normal skin left. During all the years before that, no matter what we did with the doctors just aggravated the situation, and made them grow more. Over 15 long years, this was happening. And what did I see just in few months of alkalizing? They were clearing up! They were disappearing! And in really such short time after eliminating all sugars, grains and starches.

I also noticed a few months later that I had not used my eye-drops, which I used to put every single day. In fact, feeling like out-of-this-world was only for a few moments of the day, as before I only felt normal a few times a day. Hmm… I realized that all this time I thought I needed to eat every few hours to remedy this, it was actually the one causing it. The best thing when your body starts to shift to a fat burning is that you don’t need to eat all the time. And your mind stays clear throughout the day.

I was also diagnosed with pituitary related hypothyroidism. I had very low values of all the major thyroid hormones, I was cold all the time and if I turned to my side at bed I would lose a regular heartbeat. This condition we remedied with magnesium and iodine supplementation. It only took a few weeks to start noticing a difference, and I started to find it possible to duck and to sleep by my side again. Chest pain also started to fade. This was a starting point in the journey to regain my thyroid health.

Hypercalcemia was coming down very nicely as the sarcoidose became less and less active. We used Vitamin K2 as MK-7, to help to body pull out the extra calcium from the bloodstream and put it into the bones where it belongs.

In a year’s time, the heart palpitations were gone, magnesium and iodine were clearly working very well. But, a year is a long time. 365 days, day after day, after day, is a lot of days. Natural healing is the only true way to heal, but it is a slow process, and it cannot be rushed. Chest pains were only a slight twist here and now, stress levels started to normalize and I no longer needed any aid for my eyes.

Nevertheless, I was still experiencing overall fatigue, weakness, and no sexual energy. This was a tough time for me, as following the regime had gotten rid of so many of the things drugs could not, but at the same time, I had more of the troubles that I found hardest to live with. Many times I wanted to quit. Guillaume did not let me. I am truly grateful he didn’t, and really glad I didn’t.

From the start, he made it very clear that I would benefit hugely from juicing. It was too bad I could not afford a juicer at that time, but now, 2 years later, I finally got my juicer. Better late than never, but for you, if you can, start juicing right from the start. You won’t regret it!

The sarcoidose had caused the rare case of hypercalcemia and hypercalciuria. This was the only reason I had to be very cautious when supplementing with D3. Guillaume insisted many times that I start supplementing with the combo of vitamins A, D, and K2. I was hesitant, worried about the calcium levels in my blood, because hypercalcemia can become life-threatening very quickly, and even if it does not, it can do a lot of damage in a short time. Now, in retrospect, my opinion is that the root cause of the sarcoidose might actually have been the chronically low level of D3. This is what Guillaume thought, this is what he told me, and I think he was right, because things continued to get better, even if I was taking smaller doses than he would have liked me to take. If you have this rare condition, be sure to closely monitor your D-25, D-1,25 and all calcium levels when supplementing.

The sarcoidose had caused massive discomfort for a long time. It was time for it to go. Hormone levels reached rock bottom. Calcium levels started to normalize. And then, hormone levels started to go up. The sarcoidose went dormant, and the body was waking up. What it took was two years of life without carbs, alcohol, drugs or late nights. A strictly measured and timed daily regime of alkaline water, green smoothies, unrefined sea salt, loads of coconut oil, greens, nuts, animal protein and the most important supplements including vitamins A-D-K2, Iodine, Magnesium and B12. These crucial nutrients were the ones I was most deficient in. I hope when you read this, if you feel sting, start to change your life until it changes you.

Also something worth to mention is that common colds or flu’s, headaches and fevers are non-existent. I don’t even have any drugs at my home, not even for headaches that used to plaque me.

The reality is much more detailed and full of ups and downs. Following this protocol did not heal me in a day. Luckily, I had not damaged my body beyond it’s capabilities of repairing itself. I think the aim of the blog is to lead the reader to an understanding of how to give the body what it needs to function and repair itself. What I consider crucial is to get rid of the idea that drugs can help you in the long run. These writings contained a formula, but they only worked once I realized it was about me. I played a key role by letting myself get sick. The actual healing is done by the body when it is given what it needs, no matter what we think of it. The process continuously tries to find balance.

I had moments when I was going downhill so fast, that I thought what is the reason I am living according to some stranger, people around me joking about the lifestyle, thinking that I had read a blog, and had become completely insane. When I was doing it and still felt weaker, that was the crucial point as I did not give up. The route of healing is not always going for the better. Once you realize there are more good days than bad, you know you are going in the right direction. What I mean by this is that even when you are doing everything right, when you are sick, you will have bad days. But don’t give up!

I was tested many times with CT scans, MRI scans, blood testing, lung capacity testing, and all the medical procedures that are concerned with sarcoidose and other illnesses I used to have. And every time I felt better, the tests revealed the same. It was no placebo. By no means I am against medical treatment. After all, I had needed it myself. But now I understand they have their place when the situation is dire, but the actual healing process can only be done by your body. Even if you must take drugs, they usually just mask the symptoms. I hope after reading this you will understand you must be proactive with your health. Before my problems, I was living the lifestyle considered to be healthy. My story could have had a very different ending.

Writing this today, I just turned 30. So what has changed after I found this blog? Everything. I don’t miss any of my old ways. I don’t miss any of the old food I used to eat. I sure as hell won’t miss the problems that then plague my life. Two years ago I had a disease that most people spend the rest of their lives struggling with, a disease considered incurable by any medical intervention. Now I am the proud father of a little girl, who was just born a month ago! Guillaume’s help did not only save my life, it helped in the procreation of a new one.

This writing is a testimonial of this miraculous healing journey of mine. Amazingly, even I am now starting to forget all the problems I had, how crippling they were, and how difficult it was for me to live like that. For this reason, I want to share these details with everyone, so that you can know the incredible level of healing this way of life has given me.

I know saying thank you a million times are still only words. We all get a salary from our work, but when you love what you do, it is not about the money either. So what can I say or do to show my level of appreciation? Guillaume’s guidance has transformed my life. My healing process and health are the living proof of this. We have a saying in Finland: “talk is talk, action matters”. So I took action, and it has brought me freedom of the disease conditions so many people are desperately trying to get over. I too was desperate to get better. And, thanks to this blog and thanks to Guillaume, I succeeded.

So to you Guillaume, thank you. You were there for me when I was at my worst. You always had faith that everything would one day be fixed, that it was a matter of time and effort. And you were right. Not even in my wildest dreams could I have thought that this host of different problems could be fixed. I hold you in the highest esteem, and can only imagine the countless hours it has taken you to prepare and write these articles. Some of them must have taken you years of research and work. I really appreciate this. Thank you so much.

After reading this, if you decide to take the plunge, do it without hesitation. Do it before you get ill. Don’t give up if it doesn’t feel easy all the time, as life usually doesn’t. It is worth the effort. Schedule time to read all of the articles mindfully, and you will see what I mean.

All Guillaume ever wanted in return was for me to write about my experiences, to share these experiences with you. If Guillaume’s work has helped you, what I would like to ask of you, is that you help spread the word, share these articles on your social media, like, comment, subscribe and interact. Join me on Patreon, a crowdfunding site to show your support for his work. If we all help a little, together we can make a big difference.

Every word written above is true, and everything is described exactly as it happened.

If you think this article could be useful to others, please ‘Like’ and ‘Share’ it.

First high-carb-low-fat day after 8 years on a low-carb-high-fat diet

A little taste of what’s to come from the results of my experiment with continuous glucose monitoring: this roller coaster ride is what most people experience every day. What was on the menu: melon, raspberries, watermelon, (nap), coconut water, tomato salad, fresh corn, a little ‘financier aux pistaches’, and finally, popcorn to finish off the day. Can you guess when I ate? Pretty obvious, isn’t it?

Screen Shot 2016-08-07 at 14.43.43

Hypoglycaemia as a metabolic impossibility

Last Thursday, the day before the operation, the dental surgeon told me: “Make sure you have a good breakfast. I don’t want you to get hypoglycaemic. It will last several hours.” I replied: “I never have breakfast, and it is impossible for me to become hypoglycaemic.” He was like: “What? What are you talking about? I don’t understand what you’re saying.” I just said: “Because I don’t eat carbohydrates, I cannot become hypoglycaemic.” I’m not sure he understood what I meant, but I suppose that given my response, he figured I knew what I was talking about.

I’m sure you’ve heard, at one point or another in your life, someone say: “I’m hypoglycaemic, I need to have something”, and then seen them pull out a can or bottle of juice, an apple or an orange, a granola or a chocolate bar? Maybe you’ve said it yourself! It sounds scientific; like we know what we’re talking about. Don’t you think? Maybe we’ve heard a doctor or a nurse say it. Maybe we’ve heard other people say it, here and there. And over time, saying this has become common parlance in North America, and surely in the UK as well. But what does it mean? What do we mean when we say that?

Do you know why I said what I did to the dentist? Do you understand why it is impossible for me, (and possibly you too), to become hypoglycaemic, even without eating for 12, 24, or 36 hours? Why is it that so many people suffer from hypoglycaemia on a daily basis, especially type II diabetics, and all the while, I’m writing that it is ‘a metabolic impossibility’? Am I wrong? Am I lying? Am I confused or trying to be confusing? And why is there so much hype about hypoglycaemia? Just Google it and you’ll see: 6.35 million hits! There’s even a Hypoglycaemic Health Association!

First of all, if you don’t already know what it means, hypo means low, and glycaemia means ‘sugar in the blood’. So, hypoglycaemia just means low blood sugar. But the thing is that what people usually mean when they say this, is that they are feeling tired, slow, flat, low-energy, light headed, maybe even dizzy, and interpret these symptoms to reflect a state of low blood sugar, which it usually does. But there’s a caveat: different people will feel the same symptoms at different blood sugar levels! Isn’t that a little weird? Doesn’t that make you wonder about what this means and implies? If there is such as thing as hypoglycaemia, why would it be different for different people? Meaning, why would a certain blood sugar level be fine for one person, and too low for another?

But what is low blood sugar? What is high blood sugar? What is normal blood sugar? Do you have any idea? And how much sugar is that, actually, circulating in the bloodstream? Any idea about that?

Let’s make it simple. Most people have between 5 and 6 litre of blood. Let’s take 5 litres as our baseline to make the numbers easier. Most people, on average, have around 100 mg/dl of glucose in their blood (even if they should have less!) Since there are 10 dl in 1 litre, and 100 mg =0.1 g, this makes 5*10*0.1 g = 5 g. Think on that for a second: in your entire body, there are 5 litres of blood, and in this volume of blood, there are 5 measly little grams of glucose. That’s a teaspoon!

For very low blood sugar levels, we can go down to about 50 mg/dl (half the normal average). This would amount to just 2.5 g in your whole body! And for critically (as in dangerously) high levels, we can go up to around 400 mg/dl (four times the average). In this case, that would amount to still just 20 g! Therefore, we can say that at any given time in our body there is on average 5 g of sugar, very rarely less than 2.5 g, and only extremely rarely, when we are severely diabetic, up to 20 g. So, all things considered, it’s not much, is it?

Now, why is it that most people feel hypoglycaemic at one point or another if they don’t eat for a while, sometimes in as little as a few hours? Why would different people feel these symptoms more or less intensely? And why would different people feel the same unpleasant or even debilitating symptoms of hypoglycaemia at different concentrations of blood glucose?

Well, if you feel symptoms of hypoglycaemia it means that 1) your blood glucose levels are significantly lower than your own usual average level, the level at which your system and cells have gotten used to functioning. This average level could be 200, 150, 120, 100 mg/dl or whatever. And the lower threshold before you start feeling weak, tired or even dizzy could be 40, 50, 60, or even 90 mg/dl. In fact, diabetics or soon-to-be-diabetics, could be walking around, going about their business with an average of 150, 200 or even 300 mg/dl without knowing it, until they get a blood test and someone notices. And they would definitely feel hypoglycaemic at levels that could be quite high. How come?

The key to understanding this conundrum in the apparent subjectivity of hypoglycaemia is the notion of glucose tolerance. But what is glucose tolerance if it is not insulin sensitivity? And what is insulin sensitivity if it is not the flip side of insulin resistance? I hope that by now, having been reading this blog for a while, you know everything about insulin resistance, how it develops and how it manifests itself in the biochemistry and metabolic functions of the body. (If you don’t, then just reread the posts you’ll find in the Diabetes and Carbs categories.)

This notion of tolerance explains it all very neatly: with chronic exposure to glucose, (as in high average levels of glucose in the blood for an extended time), insulin resistance increases, and thus, insulin sensitivity decreases. As insulin sensitivity decreases, more insulin is needed to clear the glucose from the bloodstream, and more glucose stays in circulation longer. The cells get used to this high level of insulin, and become less and less sensitive to it, allowing less and less glucose to get in. When the level of glucose drops below the threshold at which the cells can use it without much effort, muscle but especially brain cells, we feel hypoglycaemic. This is why hypoglycaemia is defined on a subjective and relative scale that depends on our own cells’ sensitivity to insulin, the hormone that shuttles the glucose in. We become hypoglycaemic when the body cannot use fat to fuel its cells, and ketones to fuel its brain. And the more insulin resistant, the more prone to hypoglycaemia.

Moreover, insulin sensitivity, or resistance, exists on a continuous spectrum in the population. It goes from extreme sensitivity to extreme resistance. On the side of high resistance, we have type II diabetics; and on the side of high sensitivity, we have those people like me, and maybe also like you, who restrict carbohydrates, getting most of their calories from fat, and whose cells are consequently fuelled primarily by fat and not by glucose. This makes them, it makes us, not only highly metabolically efficient, but also impervious to hypoglycaemia.

This is why I said what I did to my dentist over the phone the other day: for a body whose cells are highly insulin sensitive from being minimally exposed to glucose/insulin in the bloodstream, the levels of which are delicately and sensitively regulated by the liver (glucose) and pancreas (insulin) throughout the day based on food intake, activity and stress levels, the cells are primed to burn fat efficiently, and the liver is primed to produce all the fat-derived ketones to nourish the brain, which they do far better than glucose can. For a body that works like that, it is physiologically impossible to become hypoglycaemic.

By the same token, it is also physiologically impossible to ‘hit the wall’, just because the cells are fuelled by burning fat, not glucose, and there is always a large reservoir of fat in the body, in terms of calories, at least an order of magnitude larger than the reserves of glycogen in the liver and muscles combined, and this, no matter how thin you may be. For example, even at 8% body fat (like me), which is quite low, a person weighing 63 kg (like me), has 5 kg of fat to draw on, providing a reservoir of 45 000 kcal! This is why we see more and more high level long distance athletes and professionals (like this one), and even power lifters (like this one) switching to a very low carb high fat diet (often abbreviated VLCHF). They do this to get lean and to tap into the metabolic advantages of nutritional ketosis.

Two final points:

1) Insulin sensitivity depends sensitively on exposure to insulin, which depends sensitively on the presence of glucose, which depends sensitively on carbohydrate intake. And it is as simple as this: the less carbohydrate, the less glucose; the less glucose, the less insulin; the less insulin, the more insulin-sensitive. This is always true even if different people have different genetic predispositions to insulin resistance.

2) Nutritional ketosis depends on the ratio of calories derived from fat to those derived from carbs, as well as on a specific maximum amount of insulin-stimulating carbohydrates per day. This threshold depends on each person individually. For one person it can be as high as 100-120 g, whereas for another it could be at low as 15-20 g. In addition, if you deplete your glycogen stores from going for a really long bike ride, for example, you can eat as much as 200 or even 300 g of carbs, and still remain in ketosis, because all of it will go to replete glycogen in the muscles and liver. In most people and in most cases, however, a standard guideline is less than 50 g per day. But, remember, the lower the better.

So, are you clear on what the deal is with hypoglycaemia? And now, what’s it gonna be: carbs, hypoglycaemia, feeling tired and irritable, low in energy and mentally slow, light headed and dizzy; or fats and protein, nutritional ketosis, feeling good and strong, high in energy and mentally sharp, stable and alert.  That’s a no-brainer, right? What do you say?

If you think this article could be useful to others, please ‘Like’ and ‘Share’ it.

Energetics of survival

You wake up, open your eyes. You are surrounded by lush green forest in all directions. There are lots of bees and bumble bees, butterflies and dragonflies, all of them buzzing around the wild flowers and flowering bushes, collecting pollen, sucking nectar, and eating small bugs. There are also birds of all kinds; of kinds and colours you have never seen. Some are flying, frenzied, up and down and all around, some are singing loudly and proudly, some are sitting on branches, watching you, seemingly in just as much amazement to see you there, as you are feeling looking out onto this amazing scene. You have no idea where you are, but you know it’s green, vibrant, and full of life, you know it’s a beautiful place, a wonderful place. Never in your life had you imagined a place like this could still exist in the world.

sentinelIsland

What happened is that you were brought to and dropped off on this island, untouched by people or technology, while you were asleep, after having been sedated in order not to wake up during the trip. You don’t know why, and you don’t know who did this. Fortunately, and you don’t know this yet, but there are no predators on the island. Not only that, but the weather is perfect in that it never gets too hot or too cold, too dry or too wet, and there are enough food resources for you to live on, even if you have to work to find and get what you need to stay strong and healthy. Since you are alone, you don’t have to provide for, or protect anybody other than yourself. What is your first concern?

Most probably, finding a place where you can rest and sleep, sheltered from wind and rain, and safeguarded from possible dangers or annoyances that could prevent you from getting a restful sleep. You might eventually build yourself a more permanent house, but for now you need to find a suitable cave-like place, get some branches to close the face of it, and some tall grasses and leaves to make the ground soft enough to sleep on. You get to it.

You find a place, find plenty of branches and tall grasses, get your shelter organised. And although this was as easy as you could have hoped for, it has taken you half a day, and it is now early afternoon. What’s your main concern now? Food, of course: you’re hungry! You set off in search of things to eat. You walk half an hour or so, and the first thing you find is a little patch of what looks like wild spinach. So, you pick and eat a couple of small bunches of it. It’s not bad: it tastes just like spinach, even if the leaves are smaller, and a little tougher than you’re used to. However, they’re just green leaves: you’ve had enough of them, but you’re still just as hungry as you were.

You keep walking, looking all around for edible things. Another half an hour later, or thereabouts, you notice a small bush with barely visible blueberries scattered sparsely on it. You walk up to it, and start picking and eating. You’re lucky that it’s summer. The berries are good, but they are tiny, and so sour; you had no idea wild blueberries were so small, and this sour. After about 15 minutes of carefully picking through bush, you’ve eaten the three handfuls of blueberries that were on it. But guess what: you’re still really hungry. Maybe a little less than when you set off about an hour ago, but hardly at all. Think about it: a couple of bunches of small spinach leaves, and a few handfuls of wild blueberries. That’s not much. So, you set off again.

Two hours later, you are famished, and you’re still walking around looking for food. You notice a little tree that looks like it might have something on its branches. You get closer, and you’re so happy when you realise that they are hazelnuts. There’s quite a lot, even if the tree is still quite small. Unfortunately, most of them are green. In any case, you start picking all the ones that look ripe, or at least ripe enough to be picked. You’re really happy to have stumbled upon that valuable find. You manage to collect about twenty five of them that are either ready or just about to be. You find a good stone for the purpose, and carefully break the shell of each hazelnut, one by one, cautious not to crush the nut inside. You end up with lovely, freshly shelled hazelnuts from which you peel the soft skin to reveal the soft milky white nut underneath. There are enough of them to fill your cupped hands held together. You eat them, enjoying every bite, every moment of chewing, every moment of swallowing. Even if you consciously made yourself eat them slowly and mindfully, the pleasure lasted just under a quarter of an hour. Nonetheless, for the first time today, you feel your hunger and appetite have been appeased.

It is now quite late in the afternoon, and you are feeling tired from a whole day’s walking and looking for things to eat, but you are now really thirsty: you haven’t drank in almost a day. You head back to your shelter, and about half way there, stop at a spring you noticed while walking past it in the morning. You drink to quench your thirst: probably more than a litre of the cold, fresh spring water. That feels so good. Now you feel totally full: full of hazelnuts and water. You are totally ready for bed, exhausted after such a tiring day. It’s not even 20:00 but you are bushed. You go back to the cave, and settle in for the night.

The next morning you get up, and immediately, based on yesterday’s experience, realise that your main concern is to find and get enough food to feel nourished. You figure that the easiest way is to try to catch some fish. At least if you get even just one, that will be enough for the day. You need more than leaves and berries, and that the hazelnuts will need more time to ripen. You walk to the coast. That takes you about an hour. You construct a very simple underwater trap a few meters in from the shoreline, by placing stones in a circular fashion that creates a kind of rounded wall with an opening on one side, in a way that the fish will be able to swim in, but will not be able to continue on their way out to the other side, and will thus get stuck in the shallow underwater pool. That way, you will be able to either grab the fish with your hands directly and throw it out onto the shore, or be able to harpoon it with a sharp-ended pole you would have made. Either way, your hope is that at least one fish of good enough size will get stuck in your trap. You set that up and walk off to continue scouting out the island for other food and water springs.

It’s a beautifully sunny day, and you are thoroughly enjoying walking slowly, looking around, exploring the island, discovering the landscape. A couple of hours later, you find a little valley along which runs a small stream. As you walk along the bank, a few minutes later, you come across a patch of blackberry bushes. That’s fantastic! It’s not yet peak season, but there are already a some ripe ones on the south-facing side of the thorny bushes. You haven’t had any breakfast, obviously, since you didn’t have anything you could eat, and so, you eat all the berries you can find that are ripe enough to be picked. After nearly an hour of delicately and carefully looking and picking while trying to not get all scratched up by the thorns sticking out everywhere in all directions from the long and skinny branches of the blackberry bushes, you have eaten a few handful of berries, but your arms and legs are nevertheless itchy from all the small scratches you did get; it’s just impossible not to get scratched picking blackberries. And although you’ve barely eaten the equivalent of a large bowlful of blackberries, and although you feel a barely noticeable difference in the feeling of your empty stomach, you’ve had enough of this precarious and thorny picking. You decide to go back to check on your fish trap.

You beam-line to the place you set up the trap, and make it back in a little over an hour. You are so excited when you see that there is a large fish swimming in circles in the shallow pool of your trap that you can hardly contain your excitement, but you need to be very careful with your manoeuvres to not let it slip out and swim away. You grab the harpoon you made and left on the shoreline, go up to it very slowly to avoid making waves in the shallow waters, circling around from the north side to make sure you don’t cast a shadow on the water over the trap, and with great care and attention, holding your breath both from the excitement of actually catching the fish, and the anxiety of failing to do so, you bring down the harpoon and spear the fish solidly right on the end of the sharpened stick. Fantastic! Brilliant! You never imagined how amazing and empowering it would feel: you’ve never before had to catch a fish or anything else in order to feed yourself.

You make a fire, grill the fish, and finally eat it with immense pleasure and satisfaction. You feel great, really great: totally full and totally content. It’s now late in the afternoon, but you’re ready to sleep. So, you go back to the cave, and sleep on a full stomach, calm and at ease, a wonderfully restful sleep.

When you wake up the next morning, you’re surprised by the fact that you don’t feel hungry. You’re really thirsty, but you’re not hungry. You haven’t felt like this in days. You get up, walk to the closest water spring, and drink. You drink probably the equivalent of a litre and a half, and you feel totally full. You set off and spend the day walking around, exploring and getting more familiar with the island. It’s not until the afternoon that you start to feel hungry again. So, you just go back to the beach where your trap is. You walk up to it, and man! Holy cow! There are three fishes in it! Being even more cautious then you were yesterday, you manage to catch two. The third one escapes, but this is really good anyway: you have two fish instead of just one.

Again today, like you did yesterday, you make a fire and grill the fish. But you only grill one of them to eat today. The other one, you wrap in a large banana type leaf, and place in the hot ashes on the side of the fire. You grill your fish to perfection, and eat it with as much joy and satisfaction as you did yesterday, taking your time, eating all the little bits of flesh and skin, sucking clean every fish bone. It’s so good! A couple of hours have passed now, since you started grilling, and the second fish wrapped in the leaf has now been steamed in its own moisture, making it easy for you to separate all the edible parts. Putting these aside on a small wooden platter you’ve made by weaving together thin branches, leaving enough space between them to allow air to flow through. After that you make a little structure that you can place over the fire, and on which you can set the ventilated weaved branch plate with the fish, letting it sit there, a foot or so above the ashes, making sure to maintain the coals hot, and putting dried leaves and pine needles to make smoke.

This is a slow process, and you want to dry the fish, not just smoke it lightly, because you want to be able to keep it without it spoiling. You end up doing this all afternoon and well into the night. Eventually, you fall asleep on the beach, next to the smouldering fire, and by the time morning comes, the fish is dried: you can keep it, and it won’t go bad. You’re exhausted. You hardly slept all night. You take the smoke-dried fish with you back to the cave, and go to sleep for a few hours.

When you wake up, it’s already mid afternoon. As the day before, you go drink, and then go back to the fish trap to assess the catch, but today there is nothing: not a single fish. Well, no problem, you think, there’s the smoke-dried fish back at the cave that you can have for supper. You decide to make a detour and hike back to the blackberry patch on your way back. It’s going to take some time, but you already have your plan for supper, so you enjoy the one hour walk to the valley with the blackberries. You pick and eat berries for a while, maybe a little under an hour, and then make your way back home to the cave. You take out your smoked fish, but eat only half of it. You never know if there’s going to be a catch tomorrow, and your don’t want to be left without having anything to eat for dinner the next day. Anyway, half the fish is enough to make you feel full and satisfied from your meal. You go to sleep.

When you wake up in the morning, you don’t get up right away. You lie back, and reflect on the last few days. You’ve been on the island for just three days, and in this short period of time you have understood, without having had to think about it even for even a second, the energetics of survival. You have understood, first of all, that there is no way at all that anyone living in the wild could survive for an extended time on plant foods alone. Second, you have understood that the value of foods, in terms of energetics, is measured in the amount of calories, and of the feeling of satiety or fullness they provide. Therefore, the richer in fat and protein the food, the more valuable it is: animals and animal foods come first; fat and protein-rich plant foods like nuts and oily seeds (sunflower, sesame) come second; and all other foods like berries, greens, and other edible fruits and vegetables come third. It’s plain and simple, and there’s no way around these two basic conclusions.

In addition to that, it strikes you that the circumstances in which you have landed—a place with a perfect climate, with no predators, at the best time of the year for finding and harvesting plant foods, and with an amazingly easy access to enough fish to feed yourself—really couldn’t be any better. They must have been far worse for almost every individual in all of our ancestral lineages, no matter where they might have been on the globe.

And now, considering that every human being on the planet today is a descendant of a tribe of homo sapiens that, it is believed, lived on the south western coast of Africa, ate mostly crustaceans and fish, developed larger and more versatile brains (almost surely due to their diet), and were the first ones to develop advanced language skills, which gave them a greatly increased power of communication, conceptualisation, and abstraction. Considering that it is these people that, beginning between 100 and 70 thousand years ago, started migrating northward and eastward first through and then out of Africa, reaching Polynesia and Australia around 50 thousand years ago, Europe and Asia most likely in several waves between 70 and 35 thousand years ago, their descents eventually reaching North America 12 to 13 thousand years ago, near the end of the last ice age. And considering that this last ice age lasted 100 millennia—that’s one hundred thousand years—during which every hominid on the globe, other than those living in equatorial regions, and this includes all homo sapiens and all neanderthals, must have had to live almost exclusively on animals and animal-derived foods, not just for a while, but several tens of thousands of years.

Can this even be imagined from the perspective of someone who lives approximately 80 years, but who keeps in memory a sense of time that spans much less than that? Your parents were born around 20-30 years before you. Their parents were born 20-30 years before them. Your great grand-parents, another 20-30 years before that. And do you know anything about your great grand-parents, other than possibly having seen a few pictures and heard a few anecdotes about them told by your parents or grand-parents? And this is just a period of time spanning 60 to 90 years. Think of what this means: not one hundred, not two or three hundred, not five hundred, not even one thousand years, but ten, twenty, thirty, fifty thousand years eating basically only animals, without ever knowing what it’s like to eat anything else, a whole lifelong, generation after generation, hundreds of generations after hundreds of generations.

What do you think this implies for us now? What does it say about both the essential and most important macro and micro nutrients our bodies and brains need? What our bodies and brains, these incredibly complex living systems, refined over millennia upon millennia in every aspect of their coarsest physical and mechanical, and their most subtle biochemical, hormonal and neurological functions, actually need to function properly? What does it say about what we, as human beings, have evolved over these vast periods of time being dependent upon to be healthy, survive and reproduce?

If you think this article could be useful to others, please ‘Like’ and ‘Share’ it.

Vitamin C is not vitamin C

Several years ago now, when I read The Calcium Lie, I found out that vitamin C and whole food vitamin C complex were not the same thing. I wasn’t surprised in the least because obviously this is surely the case for most supplements: an extract is not the whole food. But a few days ago, I saw a short video presentation that forced upon me the realisation that there is a huge functional difference between what is sold as vitamin C and the complex vitamin C molecule we find in whole foods.

wholefoodvitaminc

The distinction may seem trivial at first—it has on the whole clearly been missed—but it is rather important: ascorbic acid, that has been equated to and sold as vitamin C, is the substance from which is made the thin antioxidant shell that protects the many constituents of the vitamin C complex as it is found in food. Since ascorbic acid can be produced in a lab, whereas whole vitamin C complex can only be found and extracted from real food and therefore cannot, this is naturally what has been done: manufacture ascorbic acid and sell it as vitamin C.

This makes sense, of course, because none of the supplement manufacturers would be inclined to emphasise this point. It would be kind of like shooting themselves in the foot. But also because, given the proven biochemical and physiological value of antioxidants, it’s not a far stretch to convince oneself that the usefulness of vitamin C is, in fact, derived from the effects of the ascorbic acid shell. For this reason, when I read Dr Thompson’s comments on vitamin C, I made a point to pile on the red peppers, brocoli and lemons in our diet at home, but nonetheless kept on taking ascorbic acid supplements and do to this day. This is about to change.

Dr. Darren Schmidt is an American chiropractor who works at the Nutritional Healing Center of Ann Arbour and, as most chiropractors, practices natural medicine, treating thousands of patients each year, most of them suffering from the same kinds of complaints, aches, pains and disorders, as is the case everywhere else. The talk was about heart disease: number one killer in the US and very prominent in all industrialised countries. To make it as clear and simple as possible and get the message across, he described that heart disease arises from the gradual filling up of the coronary arteries supplying blood to the heart with arterial plaques that with time grow to block the way completely or almost, and that this leads to a heart attack. We covered this topic in detail in the article At the heart of heart disease.

The main point he wanted to get across is that plaques in the arteries and blood vessels develop because of an injury to the tissues lining the vessels, just like a scab does on the surface of the skin when we accidentally scratch, scrape or cut it, and that a well-functioning organism will fix that injury in the same way as it does the surface of the skin: the scab forms, the skin repairs itself underneath, and when it is healed, the scab falls off. Plaques are like scabs.

He explained that, fresh out of university in the early 90’s, he had heard at a conference someone speak of the work of a great pioneer in nutritional medicine of the first half of the twentieth century, Dr Royal Lee, a friend and colleague of the other great pioneer Dr Weston Price. Dr Lee was the man who made the first food supplement, and the first concentrated whole food vitamin C supplement. He founded in 1929 the Vitamin Products Company, which later became Standard Process, Inc. Lee taught that this concentrated food in tablet form was like a pipe cleaner for arteries. Hearing this, the young chiropractor thought to himself, if it worked then it should work now, and he began to prescribe vitamin C to all his heart disease patients. For a decade he prescribed vitamin C, and for a decade he failed to see significant improvements or any sign of reversal of atherosclerosis in his heart disease patients. But he had missed something.

Frustrated and disappointed, he looked again at the original research and writings of Drs Lee and Price about nutrition and disease, and in particular about vitamin C, and began prescribing only Standard Process vitamin C. What he found, invariably, was a quick improvement in his patients whose chest pains and complains would disappear, and who would gradually feel better and better. Since then, he has repeated this on thousands of people with such success that he now teaches, he now repeats what Dr Royal Lee taught almost a century ago, that the cure for heart disease, for disease of the arteries and atherosclerosis, is vitamin C. And that vitamin C is not ascorbic acid, but it is whole food vitamin C complex.

Schmidt is not handsome nor charismatic. He does not speak eloquently. He is far from refined in his choice of words and speaking style. He doesn’t come across as a brilliant doctor or scientist, and not even as a bright guy, really. But the clinical experience and observations on which his statements and claims are based are undeniably impressive and clearly unambiguous in the information they convey: ascorbic acid has no effect on healing injured tissues and in allowing for the body to clean up and remove the plaques from the arteries and blood vessels; whole food vitamin C complex does, and it does so remarkably well and efficiently in everyone who takes it.

The implication is that other than providing antioxidant effects, ascorbic acid is useless for aiding and promoting healing of tissues. In this case, the concern is the health of the arteries, but it’s not a far stretch to conclude that this applies to all injured tissues in general. What is needed is whole food complex vitamin C, which we eat in whole foods or take in supplements that are made from whole foods. Therefore, it’s a no brainer: if you are interested in keeping your arteries clean and your heart and brain healthy and well-functioning for as long as possible, take a whole food vitamin C complex supplement, and pile on the vitamin C rich foods in your diet (superfoods highest in vitamin C include Camu Camu, Acerola and Goji ; regular foods highest in C include bell peppers, broccoli, brussels sprouts, strawberries and kiwi).

There is one last crucial point to this story, and I was happily surprised to hear it mentioned during the presentation. It is something that is explained by Gary Taubes in Good Calories, Bad Calories, but that is very rarely heard or mentioned anywhere. Vitamin C enters cells through the same channel as sugar does. But for evolutionary reasons, glucose always takes precedence over it (and all other nutrients). Therefore, as long as there is sugar to be shuttled into the cell, vitamin C stays out and waits: it does not enter the cell. So, what does he suggest for the diet? Can you guess? No sugars (simple carbohydrates), no starches (starchy carbohydrates) because they become sugars, lots of fat, adequate protein from healthy animal sources, and lots of green veggies, Sounds familiar? And, of course, whole food vitamin C concentrated in supplement form.

Finally, I promise to write about these and other great pioneers of nutritional medicine. I feel that these people who were greatly ahead of their times and usually greatly suffered from it deserve more recognition than they get. They deserve more recognition than they ever will get. But still, I would like to do my part. I don’t know when, but I will.

If you think this article could be useful to others, please ‘Like’ and ‘Share’ it.

In light of evolution

Every animal in the Natural World is bound to live according to its own nature. This is dictated by 550 million years of evolution since the emergence of complex organisms including the very first ancestor of all animals on the planet today. To live according to its own nature means to live in its natural habitat, to eat what it has evolved to eat, to grow, mature, reproduce, age and die according to the way in which every detail of every aspect of its life has been defined and refined by the environment and living conditions of its ancestors over hundreds, thousands, millions of years.

As conditions change, natural selection ensures adaptation. On this question, there are only two possibilities: adapt and evolve or perish and disappear from existence. And this is not a matter of choice or of willingness: it is a biological adaptation that takes place on its own without the conscious intervention of the organism subject to the process.

In the Natural World, through the entire history of life on Earth, it has been thus. It has been thus for the very first living microorganisms, for the very first photosynthetic cyanobacteria, for the first eukaryotes and the first multicellular organisms, for all algae, fungi and plants, and for all animals. It has also been true for humans, for the human animal, the human chordate, the human mammal, the human primate. True, until very recently.

This is what I understood on that day when I watched, shocked and amazed, that female sheep swallow up her own placental tissues dripping with blood almost immediately after she had given birth to that helpless lamb that was lying unmoving in the shade of a large oak tree.

The earliest dates for which we have evidence that people settled in relatively large settlements and sustained themselves by cultivating cereal grains and tending to herds of domesticated animals is about 10 to 12 thousand years ago. Before that, all human populations throughout Africa, Asia and Europe were seasonal nomads that followed the animals on which they relied for food, clothing and tools.

An exception to this might be the south Pacific (Melanesia and Polynesia), lands that were settled some 50-60 thousand years ago, but that, unfortunately for those settlers, had little food resources: no large seeded grasses, no easily domesticable animals, and very few fruit-bearing trees or edible wild vegetables. They found a starchy tuber that could be eaten after some processing to remove the toxins it contains. So, this is what they survived on, and this is primarily what they still survive on today.

Needless to say that even with the intake of minimal amounts of protein from some animal sources, and today they have domesticated pigs, these people–all the different clans and tribes that evolved in that part of the world–have always been extremely restricted in their evolution by the need to devote so much time to their most essential requirement for surviving longer than a few weeks or months. Moreover, can anyone be surprised by the fact that this is the part of the world where cannibalism has always been practiced and still is practiced to this day?

If you were starved of protein, not just for a few days, a few months or even a few years, but for your entire lifetime, generation after generation, of course you would eat your dead rivals and enemies. There’s no question or doubt about it. It would be a waste not to. Not only that, but you would also certainly go out of your way to find and make rivals and enemies in order to maximise your meat base. No question or doubt about that either. Naturally, this is what we see there: hundreds of small tribes sharing the scarce natural resources in this inhospitable land by intense rivalry and continuous warring. You would do the same. I know I would. You can be sure of that.

The fundamental difference between humans and all other animals is that they are bound–forced by natural selection–to eat only what they have evolved eating. Humans are not only able to disregard this biological framework to which we really are in fact bound as all other animals are, but to actually eat and live in ways that are completely contrary to what is prescribed to them, to us, by our evolutionary history and by natural selection. This is true whether the constraints are imposed upon us by our environment, climate, geography and available resources, or defined by the beliefs that shape our worldview.

The former is the dominant in most of the world, but the latter is definitely pervasive in industrialised countries where, for practical purposes, there are no constraints on the availability of foods at any time during the year or any moment during the course of one’s whole life, really. And this is what we are addressing here: not the scarcity of food and the restrictions on dietary regimens in those struggling to get enough food for themselves and their dependents, but the effects on our health of restrictions we place on our own diet based on beliefs.

This fundamental difference is well illustrated by the fact that large carnivore like jaguars, panthers, tigers and lions eat meat exclusively. They never think about it, they don’t consider what they feel like having for supper, they don’t sometimes go grazing a little grass or other plants here and there: they always only eat meat, and have been for millions of years. Consequently, these large felines have only sharp teeth without any flat ones for grinding fibres, they have a shorter and simpler digestive tract that measures about 7 metres (compared to about 10 metres for humans), their proportionally larger stomachs secrete such strong concentrations of hydrochloric acid that the pH inside it after meals drops to values around 1 (compared to  around 2-3 for humans), the lowest (most acidic) on the logarithmic pH scale, and their livers have much greater capacity (about 10 times the one we have) to concentrate uric acid out of the bloodstream and excrete it in the urine.

Cows, bisons, buffalos; sheep, goats, lamas, alpacas; horses, ponies, donkeys, mules and so many other animals eat a diet that consists of basically only grass and grass seeds, have completely different adaptations: they have large thickly enamelled flat teeth for grinding over and over again, and for hours on end throughout the day, those tough cellulose structures of the plant that lock in the nutrition they need to extract, they have extra long digestive systems, some of them with several stomach-like sacs along the way, that actually allows the chewed up grasses to travel back and forth a number of times to maximise the extraction of nutrients, and they have a purely alkaline digestive system, secreting no hydrochloric acid at all, simply because this is what is most suitable and necessary for the optimal digestion and absorption of the sugars, minerals and vitamins present in the grass they live on.

These are just a few examples of evolutionary adaptations to a diet of only meat seen in obligate carnivores like large felines or in herbivore grazers, but they are most appropriate because they pertain to the digestive system on which is built every other system and on which our health and survival depends most directly.

Like feline carnivores, herbivores do not think about what they will eat for their next meal, what they feel like having for breakfast or for lunch. They always eat the same things, grasses and other little leafy plants, and in the late summer, fall and winter, the seeds of the grasses and other plants that have dried and gone to seed. How much of each depends on where they live and how the climate is. It never depends on their thoughts and feeling about what they should eat. And if we were to offer the lion or the tiger something other than fresh meat, a nice big bowl of freshly cut grass or grass seeds like oat kernels, for example, they wouldn’t touch it because for them, it is not food. If we were to offer a cow or a horse a big juicy steak from a gazelle or antilope they would in exactly the same way not even look at it or sniff it because for them, this is not food.

All animals eat only the foods that they have evolved to eat in order to live healthy for the right amount of time to allow them to reproduce and raise their offspring to the point where the offspring can themselves do the same for the next generation. For millions of years this process takes place and refines every detail of the unique characteristics of their bodies, of their physiologies and their biochemistries, of their physical aptitudes and their psychological makeup. Animals do not comprehend this: they know it in their natures, they know it in their instincts, they know it in their very bones.

We, humans, have the ability to comprehend this, at least when it is taught or explained to us, but because we think, we analyse, we believe, we rationalise, we justify and we convince ourselves and others of basically anything we want using more or less clever logic, more or less sound analyses and rationalisations, and, in the end, more or less convincing arguments and justifications. And we excel at this. We excel at it remarkably.

What comes of it? We end up eating and drinking whatever we believe we can or whatever we believe we should, whatever the reason or lack of reason. We eat bread and jam every morning because this is what we’ve always done, because this is what our parents always did, because this is what everyone around us has always done, and because it tastes so good. We eat at McDonald’s, Burger King, Taco Bell or Pizza Hut at lunch because it’s fast, convenient, and also because it tastes so damn good. We feed ourselves and our kids pasta with jarred tomato sauce for supper because it’s the easiest meal we can make, everyone loves it, and it leaves us with a feeling of being full and satisfied. We eat only plant foods. We eat only animal foods. We eat only raw foods. We eat only brown rice. We eat only salad. We eat no fat. We eat mostly fat. We eat no carbs. We eat mostly carbs. We eat in this way or in that fashion. We eat in all sorts of ways for all sorts of reasons and we somehow never ask ourselves what has this body evolved to eat: what we should eat.

In this respect, the situation between humans and all other animals is, at this stage, radically different. So different it couldn’t be more different: animals instinctively eat only what they have evolved eating and therefore evolved to eat; we eat only what we feel like eating or what we think or believe we should. We have lost our food instincts and overrun them with beliefs. We do not care to ask ourselves what our evolutionary history, that of our species as well as that of our personal ancestry, tells us about what we have evolved eating, and we trust the word of food “scientists” that tell us preposterous things such as eating egg yolks and animal fats causes heart disease, or that eating large sweet fruits and whole grains is good for us, or that we should drink milk to have strong bones, or that a big brain like ours needs lots of sugar. All preposterous. All mistaken. All unfounded. But we believe. And we listen. For decades on end before the weight of evidence begins to turn the light around. All the while getting fatter and sicker eating inappropriately for our constitution.

There are at least two ways by which we can approach the problem of trying to figure out what our long past ancestors would have eaten and preferred eating through the millennia given the constraints imposed upon them by the environment and climate: we can consider the archaeological evidence we have gathered, and combine that with as much as we have learned in the realm of evolutionary biology and physiology, trying to trace back the evolution of the different systems of the body, in particular the digestive system, coupled with the evolution of our brain; the other approach is to look at the energetics of survival and work our way through a series of deductions based on what we know and what we can learn from this process itself.

One of the important differences between our closest cousin, the modern chimpanzee, and ourselves is that a chimp eats mostly raw, fibrous plant foods (2/3 stems and leaves and 1/3 small fibrous fruit), and spends many hours each day chewing through these in order to feed itself. As a result, very strong jaws and thickly enamelled teeth together with a long digestive tract through which all these fibrous and nutrient-poor foods must pass as slowly as possible to extract as much as possible out of them. Naturally, this requires a specific kind, and well-developed intestinal flora. As is also natural to expect, and as is in fact the case, the intestinal flora of microorganisms upon which animals depend for proper digestion, and ultimately for survival, develops and adapts to the foods eaten that make their way through the intestines, on the long term, of course, but also on the short term.

What we see in the fossil record is that, following the Miocene that lasted for about 18 million years from 23 to 5 million years ago and that was dubbed the golden age of the apes because they flourished all over the world, there were, in different parts of the world, between 13 and 9 million years ago, several genera of hominoids (something between apes and hominids), and that the earliest members of our group lived at the end of the Miocene and beginning of the Pliocene between 7 and 4.5 million years ago. Molecular studies on DNA also suggest from a completely independent analysis (rate of DNA mutations) that our line must have branched off from the common ancestor we share with chimpanzees around 6-7 million years ago. So it is pretty clear that this is the time around which this separation of lineages must have occurred.

There are two lines of structural changes used to evaluate and follow the evolution we are trying to trace from that oldest ancestor to the modern forms in our genus Homo: The first looks at changes that, in the structure of the skeleton, especially in the hips, legs and feet, but also in the shoulders, arms and hands, betray evidence for an upright walking posture and manual dexterity as opposed to structures consistent with knuckle walking and tree climbing; the second looks at changes in the upper spine, skull, jaws and teeth that also indicate upright posture (skull) and less ape-like features including smaller canines, smaller top and brow ridges, and a flatter and taller face and forehead. Both lines of evolutionary changes lead to the following scenario as the most likely.

Currently, the best contenders for the title of our last common ancestor with the chimp are Sahelanthropus tchadensis (dated at 6-7 million years), Orrorin tugenensis (dated at 6 million years), and Ardipithecus (kaddaba at 5.8-5.2 and ramidus at 4.5-4.3 millions years). All of these fossil species, no matter how little evidence there actually is in some cases, show strong evidence for evolutionary adaptations to upright walking based on the shape of the hip bone or femur or feet or skull. Teeth and skulls also show smaller canines and larger and thicker molars both of which indicate that they ate tougher more fibrous foods like leaves, stems and roots.

As is very clearly illustrated in the figure below, from the oldest australopithecines (africanus), the trend towards larger, flatter and even more thickly enamelled teeth, wider and stronger jaw bones, and thicker skulls with powerful top ridges and sideways flaring cheekbones all constructed to sustain the pressure generated while chewing, continues to later species and peaks in Paranthropus Boisei, believed to be the last of the australopithecines, and probably the most robust of the toughest fibre-chewers ever. But while the trend towards narrower hips, longer femurs, thicker heel bones and higher foot arches, all needed to increase mechanical efficiency in upright locomotion, continues to be evident in the later species, we see a reversal in the trend towards better fibre-chewers, in the shrinking of teeth and jaws, the disappearance of the top ridge and flaring cheekbones, and the decrease in brow ridge in the fossils of Homo habilis and in the very well preserved 1.6 million year old Turkana or Nariokotome Boy, the best specimen we have of our ancestral species Homo ergaster.

hominidEvolution-skullsAndJaws-3stages

This is most naturally and sensibly interpreted as the adaptation from a chimp-like diet based primarily on fruit and other plant foods with the rare feasting on animal flesh from  group hunts of thought to be important mostly in establishing a clear social order in their hierarchical structure, in the oldest australopiths; to a change in diet towards tougher and more fibrous and naturally less desirable leaves and stems, fallback foods, as they are called, that were available to them after migration out of the depths of the forest and into the dry savannah; and to eventually the shift towards more fibre-less animal foods, rich in calories from fats and protein, only a very small amount of which was necessary for survival in comparison to the amount of fibrous and nutrient-poor plant foods.

The implications are clear and also obvious: 1) More fibrous nutritionally-poor plant foods led to adaptations for chewing them but also for processing them internally and must have been associated with a longer much more herbivore-like digestive tract and system. 2) More nutritionally-rich fibre-less animal foods led to the loss of the need for large teeth, powerful jaws and thick skulls, and also must have led to a shrinking of the digestive tract and evolution of digestive adaptations needed to process animal protein and fat, which would include the need for hydrochloric acid in the the stomach to breakdown protein, and bile from the liver to emulsify fats, as well as a new bacterial flora which would have also been entirely different depending on the diet. And 3) the more animal foods were eaten, the more the brain grew in volume, both in absolute terms and relative to body size.

These are the most important conclusions from this exploration of our earliest evolutionary history as a species, which also very closely tie-in with our reflections about what we choose to eat and the reasons we invoke or construct in justifying these choices to ourselves and others, because it shows us as plainly and straight-forwardly as is possible to imagine, that in order to live healthy and thrive throughout our life over its natural lifespan, we are bound to eat what our ancestors have evolved eating in exactly the same way as all other animals are, and that this is dictated by our anatomy, physiology and biochemistry, independently of what we think and of what we believe.

In the next part, we will explore the question of energetics and food selection, what a hominid would naturally do–what you and what I would do–when faced with the need to seek out food for its own survival, and come back to my own story in more practical terms. And if you are interested in reading more about the topics we touched upon in this article, I recommend Ian Tattersall’s Masters of the Planet, Daniel Lieberman’s The Story of the Human Body, Jared Diamond’s The Third Chimpanzee, and Yuval Noah Harari’s Sapiens: A Brief History of Human Kind. Darwin’s On the Origin of Species is truly remarkable in scope, in detail, in depth and in foresight. Even if it doesn’t relate specifically to the details of the evolution of our genus Homo, it is the foundation of the broadest context in which we as intelligent and literate being understand evolution of all species everywhere since the emergence of life on this planet.

If you think this article could be useful to others, please ‘Like’ and ‘Share’ it.

The sun, our Earth, and the colour of your skin

Skin colour is the most obviously visible manifestation and expression of our evolutionary history. This history is carried over the course of hundreds of thousands of generations and tens of thousands of years. What we have to understand is that each one of us—as an individual, a person, a self—has nothing to do with the colour of our skin, the colour of our skin has nothing to do with us, and we have no choice in the matter. What we must also understand is that to be optimally healthy, we have to live and eat in accordance with the colour of our skin and what information it carries about our ancestry. All of this is true for you, and it is true for everyone of every colour in the magnificent spectrum of human skin colours as it exists on the planet today. Let me explain why.

skinColourPalette

(Photo credit: Pierre David as published in this article of the Guardian)

The Sun, like every other star in the universe, formed from the gravitational collapse of a huge cloud of gas. This happened about 5 billion years ago. All the planets, like every other planet everywhere in the universe, formed from the left over debris that wasn’t needed or used in making the Sun, and that remained orbiting around it in a large, flat accretion disk consisting of 99% hydrogen and helium gas and only 1% of solid dust particles. In a blink of an eye, a million years or so, the disk was replaced by a large number of planetesimals. An additional couple hundred million years or so, and the planets of our Solar system were formed.

Beyond the snow line, the radius from the Sun past which water can only exist as ice and where the temperature is below -120 C, volatiles froze into crystals, and were formed from massive icy cores the gas giants: Jupiter (the king at 320 times the mass of the Earth), Saturn, Uranus and Neptune. Within the snow line were formed the rocky planets: Mercury, Venus, Earth and Mars. About 4.5 billion years ago the Solar system was in place. It was in place but not quite like we know it today. It was fundamentally different in several ways, especially in regards to what concerns us here, which is how the Earth was: a fast-spinning burning inferno of molten rock spewing out of volcanos everywhere and flowing all over the globe, completely devoid of water, oxygen, carbon and other volatiles species.

The Earth formed more or less simultaneously with a very close neighbour about the size of Mars. Inevitably, soon after their formation, they collided. This apocalyptic encounter tilted the Earth off its original axis and destroyed the smaller planet that, in the collision, dumped its iron core into the Earth, and expelled about a third of our planet into the atmosphere. Most of the stuff rained back down, but some of the material lumped into larger and larger lumps that eventually resulted in the moon, our moon. When it formed, the moon was a lot closer—it would have looked twice as large as it does now, and the Earth was spinning approximately five times faster than it does today—a day back then would have lasted only 5 hours. Because of the proximity between them, huge tidal forces would have deformed the liquid Earth on a continuous cycle driven by its super short 5-hour days. This would have heated the Earth tremendously by squeezing its insides from one side and then from the other, and caused massive volcanic activity all over the globe.

But this inelastic gravitational interaction, this drag of the moon on the Earth worked, as it still does, to sap rotational energy from the Earth and transfer it to the smaller and far less rotationally energetic moon. This made, and continues to make, the Earth slow down, the moon speed up and therefore drift out into a progressively larger orbit. The moon’s drag on the Earth continues to make the Earth’s spin slower and the moon’s orbit larger, but at an increasingly slower rate, now of 3.8 cm per year. This will continue until there is no more rotational energy to be transferred from the Earth to the moon, at which point we will be tidally locked in order with the moon, and not only will we always see the same side of the moon as we do today, but the moon will also always see the same side of the Earth. For what it’s worth, this will happen way after the Sun has come to the end of its life, and thus in more than 5 billion years. So, for now, this is definitely not a major issue.

Besides this important difference in the Earth’s spin rate and its relationship with the moon, there were a lot of left overs from the Sun’s formation that had clumped up in asteroids and comets whirling around in all sorts of both regular and irregular orbits that had them sweeping across the Solar system from the furthest reaches and most distant places to the inner regions near the Sun and rocky planets. The Heavy Bombardment lasted for a period of approximately 500 million years from about 4.3 to 3.8 billion years ago. During this tumultuous early history of our Solar system, a lot of these asteroids and comets flying past the Earth and the other rocky inner planets were gravitationally captured and pulled in towards the planet to crash on the surface or just swoop down into the atmosphere, leaving behind all or some of their mostly volatile constituents: water and carbon compounds. The Earth would have been regularly bombarded by massive asteroids, and the energy dumped by the impacts would have made it a hellish place covered in flowing lava, obviously without any crust, but rather only molten rock flowing everywhere and volcanos spewing out noxious gases and spilling out more molten rock that merged into the already flowing streams of lava. Very inhospitable.

But with these brutal hundreds of millions of years of bombardment from asteroids and comets, water and carbon compounds were brought to our planet. Given how hot it was, the water was in the atmosphere as vapour, and so were the carbon monoxide and dioxide as well as methane. However, these were now bound to the planet gravitationally and couldn’t escape back into space. Once the bulk of the randomly orbiting solar system debris had been cleared out and incorporated into the various planets onto which they had fallen, the bombardment came to an end, and the Earth started cooling down. It is believed that the last major sterilising impact would have hit the Earth around 3.9 billion years ago.

Cooling during a few thousand years allowed the formation of a thin crust. Further cooling then brought on thousands of years of rain that dumped most of the water vapour from the atmosphere onto the surface. This formed vast planet-spanning oceans. The whole planet was at this point still super hot, but also super wet, and therefore super humid, with the surface practically entirely underwater, lots of active volcanos all over the place but otherwise no mountains. Nevertheless, there would have been some  slightly more elevated places, like on the flanks of volcanos, that would have been dry at least some of the time, leaving some spots where water could accumulate in ponds and stagnate. As soon as these conditions were present, around 3.8 billion years ago, the Earth saw its first microbial life emerge.

Claims for the earliest evidence of life at 3.8, 3.7 or 3.5 billion years are still controversial, but it is well established that hydrogen cyanide dissolved in water produces a diversity of essential biological molecules like urea, amino acids and nucleic acid bases; that formaldehyde in slightly alkaline water polymerises to form a range of different sugars; that amino acids, sugars and nucleic acid bases as well as fatty acids have been found in carbonaceous meteorites; and that by 3 billion years ago, prokaryotes (organisms made of cells without a nucleus) were widespread.

There was a major problem, a major impediment to life, that had to be overcome. This was the fact that the entire surface of the Earth was exposed during the day to the Sun’s UV radiation, and UV rays destroy biological structures and DNA. The cleverest of tricks would have been to find a way to absorb these energetic photons and use the energy for something.

Nature is very clever: by 3.5 billion years ago, chlorophylls believed to have developed in order to protect proteins and DNA of early cells appeared, and chlorophyll-containing cyanobacteria—the oldest living organisms and only prokaryotes that can do this—had developed the ability to absorb light, use that energy to split water molecules and use the free electron from the hydrogen atom to sustain their metabolism, spewing out the oxygen in the process. Oxygen accumulated in the crust for a billion years before the latter became saturated with it and unable to absorb any more. Evidence for increasing oxygen levels in the atmosphere is first seen at around 2.5 billion years ago. By 2.2 billion years ago, oxygen concentrations had risen to 1% of what they are today.

Increasing concentrations of reactive and corrosive oxygen was devastating for all forms of life that, at this stage, were all anaerobic: the oxygen was combining with everything it got in contact with creating all sorts of reactive oxygen species (free radicals) that went around causing damage, exactly as they do in our bodies and that of all animals today, and which, in the absence of antioxidants to neutralise them accelerated ageing and death. These were the only card that these simple anaerobic organisms were dealt.

Nevertheless, for another reason entirely, atmospheric oxygen was a blessing because it turned out to be an excellent UV shield. Not only that, but the splitting of oxygen molecules (O2) into oxygen atoms promoted the recombination of these free-floating oxygens into ozone (O3) that turns out to be an even better UV absorbing shield. So, the more photosynthesis was taking place on the surface, the greater the concentration of atmospheric oxygen grew. The more molecular oxygen there was in the atmosphere, the more ozone could be formed. And the more ozone there was to protect and shield the surface from the harsh UV radiation from the Sun, the more complex and delicate structures could develop and grow. Pretty cool for a coincidence, wouldn’t you say?

By 2 billion years ago—within 200 million years—the first eukaryotes appear (organisms made of cells with a nucleus). This makes good sense considering that these simple organisms and independently-living organelles had a great survival advantage by getting together in groups to benefit from one another and protect each other behind a membrane while making sure the precious DNA needed for replication and proliferation was well sheltered inside a resilient nucleus. Note here that these would have been trying to protect themselves both from the damaging UV radiation streaming down from the Sun (it’s estimated that DNA damage from UV exposure would have been about 40 times greater than it is today), as well as from the corrosive oxygen floating in the air (imagine how much more oxidising it is today with concentrations 100 times greater than they were). And in there, within each of these cells, there were chloroplasts—direct descendants from the first UV absorbers and converters, the cyanobacteria—whose job was to convert the photons from the sun into useful energy for the cell.

In all likelihood unrelated to this biological and chemical evolution of the Earth’s biosphere and atmosphere, a long period of glaciation between 750 and 600 million years transformed the planet into an icy snow and slush ball. And with basically all water on the surface of the globe having frozen over, all organisms under a thick layer of ice and snow, photosynthetic activity must have practically or completely ceased. Fortunately, without liquid water in which to dissolve the atmospheric carbon dioxide into the carbonic acid that in turn dissolves the silicates in the rocks over which is streams and carries down to the ocean floor for recycling by the active tectonic plates, all the carbon dioxide sent into the atmosphere by the volcanos just accumulated. It is believed to have reached a level 350 times higher than it is now. This is what saved the planet from runaway glaciation.

Thanks to this powerful greenhouse of CO2, the ice and snow eventually melted back into running streams and rivers, and flowing wave-crested seas and oceans. With water everywhere and incredibly high concentrations of CO2, plant life exploded. And soon after that, some 540 million years ago, complex animals of all kinds—molluscs, arthropods and chordates—also burst into existence in an incredible variety of different body plans (morphological architectures), and specialised appendages and functions. This bursting into life of so many different kinds of complex animals, all of them in the now already salty primordial oceans, is called the Cambrian Explosion. Complex plant life colonised the land by about 500 million years ago, and vertebrate animals crawled out of the sea to set foot on solid ground around 380 million years ago.

Clearly, all plant life descends from cyanobacteria, first to develop the ability to absorb UV radiation, and without complex plant life, it is hard to conceive of a scenario for the evolution of animal life. The key point in this fascinating story of evolution of the solar system, of our Earth and of life on this planet as it pertains to what we are coming to, is that the light and energy coming from the Sun are essential for life while being at the same time dangerous for the countless living organisms that so vitally depend on it. In humans and higher animals this duality is most plainly and clearly exemplified by the relationship between two essential micronutrients without which no animal can develop, survive and procreate. These vital micronutrients are folate and vitamin D.

What makes folate (folic acid or vitamin B9) and vitamin D (cholecalciferol) so important is that they are necessary for proper embryonic development of the skeleton (vitamin D), and for the spine and neural tube as well as for the production of spermatozoa in males (folate). Vitamin D transports calcium into the blood from the intestinal tract making it available to be used in building bones and teeth; folate plays a key role in forming and transcribing DNA in the nucleus of cells, making it crucially important in the development of all embryonic cells and quickly replicating or multiplying cells (like spermatozoa).

Here’s the catch: vitamin D is produced on the surface of the skin (or fur) through the photochemical interaction of the sun’s UV-B rays and the cholesterol in the skin; folate is found in foods, mostly leafy greens (the word comes from the latin folium that means leaf), but it is broken down by sunlight.

What this translates to is this: too little Sun exposure of the skin leads to vitamin D deficiency, which leads to a deficiency in the available and useable calcium needed to build bones, which in turn leads to a weak, fragile and sometimes malformed skeletal structure—rickets; too much Sun exposure leads to excessive breakdown of folate, which leads to folate deficiency, and which in turn leads to improper development of the quickly replicating embryonic cells of the nervous system and consequent malformation of the neural tube—spina bifida.

The most important thing of all for the survival of a species, is the making and growing of healthy babies and children so that they can make and grow other generations of healthy babies and children. This is true for all living beings, but it is not just true: it is of the highest importance, and it has been—taking evolutionary precedence over everything else—since the dawn of life on Earth. Here is how the biochemistry of the delicate balance between these two essential micronutrients evolved.

Six to seven million years ago, our oldest ape-like ancestors walked out of the forest and into the grassy savannah most probably to look for food. (Isn’t this what also gets you off the couch and into the kitchen?). It is most probably the shift in climate towards hotter and dryer weather and, in response to that, the shrinking of their woodlands, that pushed them to expand their foraging perimeter out into the plains that were growing as the forests were shrinking.

Our first australopith ancestors, these ancestors that we share with modern chimpanzees, would have been in all likelihood covered in hair with pale skin underneath (just as chimps are today), their exposed skin growing darker in time with exposure to sunlight. Having left the forest cover, they were now exposed to the hot scorching Sun most of the day, while walking around looking for food, before going back to the forest’s edges to sleep in the trees.

Natural selection would now favour the development of ways to stay cool and not overheat. This meant more sweat glands to increase cooling by evaporation of water on the surface of the skin. It also meant less hair for the cooling contact of the air with the wet skin to be as effective and efficient as possible. But less hair implied that the skin was now directly exposed to sunlight. To protect itself from burns and DNA damage, but also to protect folate, natural selection pushed towards darker skin: more melanocytes producing more melanin to absorb more photons and avoid burning and DNA damage.

In these circumstances, the problem was never too little sun exposure; it was too much exposure, and thus sunburns and folate deficiency. So these early hominids gradually—and by gradually is meant over tens of thousands of years—became less hairy and darker-skinned. They also became taller and leaner, with narrow hips and long thin limbs: this gave less surface area exposed to the overhead sun but more skin surface area for sweating and cooling down, together with better mechanical efficiency in walking and running across what would appear to us very long distances in the tens of kilometres every day, day after day, in foraging and hunting, always under a blazingly hot sunshine. This process that is described here in a few sentences took place over millions of years, at least 3 or 4 and most probably 5 or 6 million years. The Turkana boy, a 1.6 million years old fossilised skeleton is definitive proof that by that time, hominids were already narrow-hipped and relatively tall.

From an evolutionary standpoint it couldn’t be any other way. While keeping in mind that we are still talking about ancient human ancestors, and not modern homo sapiens, nonetheless, did you, as you were reading these sentences, start to wonder who today would fit such a physical description of being hairless, dark-skinned, tall, lean and narrow hipped? Naturally: savannah dwelling modern hunter-gatherers, and, of course, the world’s best marathon runners. It makes perfect sense, doesn’t it?

Taking all currently available archaeological, paleontological, anthropological, as well as molecular and other scientific evidence as a coherent whole brings us to the most plausible scenario in which all humans on the planet today descend from a single mother who was part of a community of people living somewhere on the western coast of Africa; that it is this group of modern homo sapiens that first developed and used symbolic language to communicate and transmit information and knowledge acquired through their personal and collective experiences; and that it was descendants of these moderns who migrated in small groups, in a number of waves, first into Asia and later into Europe, starting 70 to 100 thousand years ago.

It is very interesting that we also have evidence that moderns had settled areas of the middle east in today’s Israel and Palestine region as early as 200 thousand years ago, and that these moderns shared the land and cohabited with Neanderthals for at least 100 thousand years, using the same rudimentary tools and technologies, without apparently attempting to improve upon the tools they had. Meanwhile, this other group of western African coast moderns had far more sophisticated tools that combined different materials (stone, wood, bone), as well as decorative ornaments and figurines.

Thus, although equal or close to equal in physical structure, appearance, dexterity and skills—a deduction based on fossils and evidence that newer and better tools were immediately adopted and replicated in manufacture by moderns to whom they were introduced by other moderns—it is clear that different and geographically isolated communities of moderns ate differently, lived differently, developed differently and at different rates.

This is not surprising, really. Some children start to speak before they turn one, while other do not until they are two, two and a half or even three. Some children start to walk at 10 or 11 months, while others just crawl on the ground or even drag their bum in a kind of seated-crawl until they are three or more. And this is for children that watch everyone around them walking all day long, and listen to everyone around them speak using complex language also all day long. Now, what do you think would happen if a child grew up without being exposed to speech? Why would they ever, how could they ever start to speak on their own, and to whom would they speak if nobody spoke to them?

Fossil evidence shows that the structures in the ear and throat required for us to be able to make the sounds needed for refined speech and verbal communications were in place (at the very least 200 thousand years ago) tens and even hundreds of thousands of years before the first evidence of symbolic thought (70-50 thousand years ago) and together with it, it is assumed, advanced language.

Symbolic thinking in abstract notions and concepts is the most unique feature of our species. It is the hallmark of humans. And it is the most useful and powerful asset we have in the evolutionary race for survival. Sophistication in symbolic thought can only come with sophistication in language and in the aptitude for language: it is only by developing and acquiring more complex language skills that more complex symbolic thinking can come about, and more sophisticated symbolic thinking naturally leads to developing a more sophisticated and refined language in order to have the means to express it.

It’s surely essential to recognise that this is as true for our ancestors, those that developed that first symbolic language, as it is for you and me today. The difference is that then, the distinction was between those few moderns that used symbolic language and those that didn’t, whereas today, the distinction is more subtle because everyone speaks at least one language to a greater or lesser extent. Nonetheless, anyone can immediately grasp what is described here by listening to Noam Chomsky lecture or even just answer simple questions in the course of an interview.

As they moved northward, settling in different places along the way, staying for thousand or tens of thousands of years, then leaving their settlements behind, either collectively or in smaller groups, and moving on to higher latitudes before settling again somewhere else, these people encountered a wide range of different climates and geographical conditions: usually colder, sometimes dry and sometimes wet, sometimes forested and sometimes open-skyed, sometimes mountainous and sometimes flat. In all cases, they were forced to immediately adapt their living conditions, building suitable dwellings and making adequate clothing. This, we know for sure, because they would have simply not survived otherwise, and it is only those that did survive that are our direct ancestors.

Evolutionary adaptation through natural selection of traits and characteristics arising from small—and, on their own, insignificant and typically unnoticeable—random genetic mutations also took place as it does in every microsecond and in every species of animals and plants. But this, we know to be a slow process that is measured on the timescale of tens of thousands of years (10, 50 even 100). Now, consider the evolutionary pressure—the ultimate evolutionary pressure—of giving birth to healthy and resilient offspring that will grow up to learn from, take care of, and help their parents. The most pressing evolutionary need at these higher latitudes was for the body to more efficiently make and store vitamin D from the incoming UV-B rays that, (and this is an important detail often overlooked or under appreciated), make it to the surface only when the Sun is high in the sky and have less atmosphere to go through. This stringent restriction on the few hours near midday when UV-B can make it to the surface is both constraining and life-saving: it is constraining because only during those hours can the essential vitamin D be made, and it is life-saving because a continual exposure to this energetic, DNA-damaging UV radiation would in time sterilise the surface of the entire planet.

The higher the latitude, the lower the Sun’s path on the sky throughout the year and especially during the winter months. Therefore, the shorter is the season during which UV-B rays reach the surface and during which it is possible for vitamin D to be produced on the skin or fur of animals. The only solution to this severe evolutionary pressure is as little body hair and as little pigmentation as possible (think of the completely white polar bears, arctic wolves, foxes and rabbits). As an aside, what else do you think as advantageous in the cold? The opposite as what is in the hot sun: more volume for less surface area; a smaller and stockier build that keeps heat better, exactly as we see in the cold-adapted Neanderthal.

Settled in a place that provides what we need to live relatively comfortably, we tend to stay there. This has always been true, and even if it has changed in the last few generations in industrialised western countries, we have witnessed this phenomenon up until very recently on islands like Sardinia, Crete, or Okinawa, remote valleys in the Swiss Alps, the Karakoram, Himalayas or Andes, and in other geographically isolated pockets of people with genetic characteristics homogenous amongst themselves but distinct with respect to other human populations. And thus across the world we find a whole spectrum—a rainbow—of different colours and shades of skin, different colours of hair and eyes, different amounts and textures of body hair, of different physical builds and morphologies, of different metabolic and biochemical sensitivities, all seen on a continuum, all dependent upon the evolutionary history of the subpopulation where particular characteristics are seen to be present or absent to a greater or lesser extent, and all of this driven by the evolutionary pressures to adapt and maximise the survival probability of our offspring, our family, our clan, our species, by optimising the amount of folate and vitamin D through the delicate balance between not enough of the latter from under-exposure to UV-B’s that produce it, and not enough of the former from excessive exposure to the same UV-B’s that destroy it.

What this tells us is that, for one thing, we have absolutely nothing to do with the colour of our skin, eyes and hair, and nothing to do with any of the physical and biochemical characteristics we have inherited. It tells us that this has nothing to do with our parents or grand parents either, really, because these are particularities that have evolved over tens of thousands of years of evolution in a very long line of ancestors that settled in a place, stayed put and lived at a particular latitude in a particular geographical setting with a particular climate. It tells us, in the most obvious manner, that because this is so, discrimination based on colour or physical features is not jut unfounded, but it is simply absurd.

If you’re black, you’re black. If you’re white, you’re white. If you’re chocolate or olive-skinned, then you’re chocolate or olive-skinned. If you are “yellow” or “red” then that’s just how it is. And who cares how you phrase it or not, try to be “political correct” and avoid speaking of it. That’s just silly. All of it is simply just the way it is. In the same way, if you’re short or tall, hairy or not, thin or stocky, it is just the way it is. However you are and whatever features you consider, there is never anything more or less about it, never anything more or less about any of these features: it is an expression of our genetic ancestry going back not just a few but hundreds of thousands of generations.

What this also tells us is that we have to take this information into account in everything we do, especially in regards to what we eat, where we live, and how much or how little we expose ourselves to the Sun’s vitally important UV-B rays. Disregard for these fundamentally important details leads to what we see in the world in this modern era where we all live wherever we want, more or less, and find ourselves with our olive or dark brown skin living in at high northern latitudes, or with our fair or milk-white skin living near the equator with strong overhead sun all year round, and see the consequent high rates of vitamin D deficiency and rickets in our dark-skinned northern dwellers, together with the similarly high rates of folate deficiency and spina bifida in our fair-skinned southern dwellers.

In general, if you are dark-skinned you need to expose your skin to the sun a lot more than if you are fair-skinned, because you will both produce less vitamin D and store less. If you are fair-skinned you need less exposure and will tend to store the vitamin D more efficiently for longer periods of time. As for folate, we all need to eat (or drink) leafy greens (i.e., foliage) and green veggies.

However, there is an additional complication that makes matters worse (far worse) That complication is that in this day and age, we all live inside, typically sitting all day facing a computer screen, and sitting all evening eating supper and then watching TV. Not everyone, of course… but most people. Not only that, but most of us all over the world now eat more or less the same things: highly processed packaged foods usually high in processed carbs and low in good, unprocessed fats, high in chemicals of all kinds and low in nutrients, and hardly any leafy and green veggies or nuts and seeds. And boy do we love our Coke, our daily bread, our fries and potatoes, our pizzas and big plates of pasta, and our sweets and desserts! Not everyone, of course… but most people. Consequently, we are all as deficient in folate as we are in vitamin D. We are all as deficient in unprocessed fats and fat-soluble vitamins as we are in all other essential micronutrients. How depressing.

But once we know this, once we have been made aware of this situation, we can correct the problem by switching to a diet of whole foods—of real foods—rich in folic acid and fat-soluble vitamins like A, D, E and K2, (the inuits, for example, get all their vitamin D and the other fat-soluble vitamins from the fat of the whales and seals they eat), and supplementing adequately to maintain optimal levels of both vitamin D (50-80 ng/ml or 125-200 nmol/L) and folate (>5 ng/ml or >11 nmol/l), especially during conception, pregnancy and early childhood, but throughout life and into old age.

There’s one last thing I wanted to mention before closing, and in which you might also be interested: can we ask if one is more important then the other, folate or vitamin D, and do we have a way to answer this question from an evolutionary standpoint? Well, here is something that suggests an answer: in all races of humans on Earth, women are on average about 3% lighter in skin colour than men of the same group. For decades, researchers (mostly old men, of course) were satisfied with the conclusion that this was the result of sexual selection, in the sense that men preferred lighter skinned women and so this is how things evolved over time. Of course, most of you will agree with me now that this just sounds like a cop-out or at best a shot in the dark from a possibly sexist male perspective.

Most of you will surely also agree that considering the question from the perspective of the importance of vitamin D versus folate is clearly more scientific in spirit than claiming sexual selection to explain the difference. And if women are lighter than men no matter where we look on Earth, this strongly suggests that it is either more difficult to build up and maintain good levels of vitamin D to ensure healthy offspring, or that it is more important. In today’s world, it certainly is true that it is far easier to have good levels of folate because even if you stay inside all day, as long as you eat leafy greens or drink green juice, your folate levels will easily be higher than the optimal minimum of 5 ng/ml, and probably much higher, like mine which are five time higher than that at 25 ng/ml.

So, for us today, especially if we eat greens, there is no question that we have to pay much closer attention to our vitamin D levels that tend to be way too low across the board all over the world. We can hypothesise that if we continue evolving over millennia following this indoors lifestyle that we have, humans everywhere will continue to lose both body hair and pigmentation, even those who live in sunny countries, because they don’t expose themselves to the Sun. I would like to encourage you to instead expose your skin to the amount of sunlight that is in accord with your complexion, drink green juice, monitor your vitamin D levels at least once per year, and take supplements to ensure both stay in the optimal range (I recommend taking A-D-K2 together to ensure balance between them, better absorption and physiological action). That alone, even if you don’t do anything else, will be of great benefit to you, and, if you are a soon-to-be or would-like-to-be mother, of even greater benefit to your child or children.

And next time you go out, and each time after that, pay attention, look and appreciate the amazing richness and beauty of all the different skin colours and unique physical features of all the people you see all around. What you will be seeing is the inestimable richness and incalculable pricelessness of our collective human ancestry expressing itself vividly and openly, nothing held back and nothing hidden, for everyone to see and appreciate.

If you are interested in reading more about the topics touched upon in this article, its contents draw from the books Life in the Universe, Rare Earth, Masters of the Planet, The Story of the Human Body and the Scientific American special issue Evolution that features the article, entitled Skin Deep, that prompted me to write this post. And please share this post: we all need to do what we can to help overcome discrimination based on race and appearance.

If you think this article could be useful to others, please ‘Like’ and ‘Share’ it.

Amazing and shocking

I saw something both amazing and shocking. In barely a few seconds my understanding of nature and my view of the world changed. What I saw on that afternoon, warm and sunny, in late spring, riding up a long hill on my mountain bike, out of a small river valley to a plateau, going home from work, was curled up quietly on the ground in the shade of a large Spanish oak tree and covered in blood. It was a newborn lamb.

newbornlambwithmom

I was so moved, I stopped on the other side of the path a good distance from the baby and its mother, and watched. Within a few seconds I noticed that the mom had a bunch of bloody tissues hanging from her behind, dragging on the ground, and that she was so seemingly bothered by it that it was consuming all of her attention. The little lamb was lying still, and I couldn’t tell how well it was, because even though it was breathing, it wasn’t moving. But the mother was busy dealing with what was surely hanging placental tissues.

What she did at that point is what shocked me: she ate the placenta and all the bloody tissues that were hanging from her. She swallowed it all up in less than a minute. That was hard for me to process. Sheep are vegetarian animals, herbivores just like goats, cows and horses: they just eat grass, bark, small fresh branches and things of this kind. I was shocked by the sight of it, but also by the clashing of my understanding of what it means for an animal to be herbivore and yet eat all this fleshy tissue and blood. How could it be? What did it mean? But what else could she have done?

The immediate realisation was obvious: all animals giving birth to babies, across the natural kingdom, whether herbivores or not, and maybe even especially herbivores, must do the same when their babies are born: they must clean everything up, and this includes eating all leftover tissues, and licking themselves and the babies clean to leave everything as traceless as possible to avoid alerting any other animals, most importantly predators, who tend to be carnivores with an exquisitely refined sense of smell, particularly for fresh blood and flesh.

What an incredible experience. This surely would not have seemed so amazing or incredible to most people a century ago, but to the eyes of a city-born, city-raised, city-living, city-dweller like me, it was amazing and it was incredible. The images from the scene I had witnessed by accident and by chance kept coming back to the forefront of my attention again and again for several weeks afterwards. Naturally, every time I rode by there to and from work, but also somewhat randomly at different times during the day, both at work and at home. It was for me an experience that revealed something profound about the natural order of things. And this triggered a cascade of small realisations about a whole bunch of things I had read over the years that highlighted connections between them and in relation to what we are, as humans, and what we need to be strong and healthy. This is what I want to share here, but will do so in a few parts.

Being vegetarian is kind of like being a human herbivore but not quite. Being a vegan is certainly closer to it, but even that doesn’t correspond to it completely. One would have to be a raw food vegan to be as close as a human can be to a herbivore. There are millions of vegetarians around the globe, especially highly concentrated in traditionally non-meat-eating places like India. There are also plenty of vegans, but a lot less. And there are raw foodists, some of which eat animal products and meat, and some that don’t. There are fruitarians that restrict their food to only fruit, typically eating mostly sweet fruit (as opposed to low-sugar, fatty fruit like avocados and coconuts). On the other end of the spectrum, there are also people who eat only animal flesh, or only red meat, or only fish, and we can be sure that there is a wide range of diets that are more or less restrictive and more or less extreme, all based on various ideas, beliefs, but also intolerances or pragmatic considerations of necessity and circumstances.

The reasons for which we adopt various diets, restricted to different degrees, are without a doubt even more varied than the diets themselves. I chose to stop eating meat for the first time when I was in high school at the age of 16, and remained vegetarian for over 20 years, with a few rare exceptions (like for example while travelling in Iran and not being able to find for periods of days anything other than white rice, baked tomatoes and kebab). Not only did I not eat meat, but I also rarely ate eggs and butter for at least the first 10 years, because, as we all “know” and so many continue to believe from years of brain washing and misinformation, these high-fat, high-cholesterol foods are dangerous for our health. This is false, of course, but whatever.

Hence, I ate as many vegetarians do: lots of sweet fruit, hearty breads and muffins, and some nuts or seeds during the day, and typically pasta or rice with vegetables at night, always keeping fat low and carbs high, but also, unfortunately, protein very low. I sometimes made lentils, kidney or lima beans on weekends. I believed—I was convinced, of course—that I couldn’t have done better for my health. I kept that up through most of high school and all of university.

After my first degree, which for me lasted five years, and after a year of travelling from Europe to Nepal overland, with much increased awareness of environmental issues, I came home and joined several food groups promoting local, sustainable, organic farming on small scales and seasonal eating in accord with regional climate, and learned about the “health benefits” and “virtues” of whole grains and cold pressed polyunsaturated vegetable oils. This is what became the essence of my diet: whole grains and beans, whole grain sourdough breads, plenty of cold pressed vegetable oils, farm vegetables, both cooked and in salads, unrestricted amounts of fruit, and some cheese, butter and eggs, everything from local farmers. Living in Ottawa with its super hot and humid summers and its frigidly cold and snowy winters, for most of the year vegetables were mostly roots, tubers and squashes (potatoes, carrots, beets, turnips, cabbage and squashes in all possible colours and forms), and fruit were basically apples and pears.

I had read such convincing literature on the health benefits and therefore importance of unrefined polyunsaturated vegetable oils from sunflower and safflower, pumpkin, sesame and grape seed, hemp and flax seeds, all cold pressed and organic, of course, that I poured them liberally over all salads, grains, beens and breads. Now I was really convinced that this was the best I could do for my health. And convinced as I was of the excellent quality of all these foods, which was indeed excellent, but also convinced of their amazing health benefits, expositions and explanations of which were found in practically every health book, magazine and radio or TV health shows, how could I not wholeheartedly adopt this way of eating recommended by all these “experts” as the most healthful, seemingly based on scientific evidence and solid reasoning, and not also teach those around me by example and through explicit recommendations?

This was to define my diet, and, from the spring of 1997, our diet with my wife who had also been a long time vegetarian. When our son was born in late 1998 we even more enthusiastically embraced this way to feed ourselves and our baby. He was breastfed for a year and a half, exclusively for the first six months, and then gradually less, smoothly over the next year. Fortunately for him, his first food at 6 months of age was avocado, an excellent high fat, moderate protein, very low carb, raw and enzyme-rich fruit that would be nourishing and easy to digest and assimilate. That was a great choice suggested by our naturopath at the time. He gradually transitioned to eating basically what we did—whole grains, beans, veggies and cold pressed oils—only for him, they were blended into a puree.

Also fortunately for him and us, because some of our local farmers made fresh butter and cheese, and sold fresh eggs from freely roaming hens, we ate more of these foods. And, of course, they were delicious, nutritious and satisfying, but somehow I still felt that we were straying from the ideal diet that would be devoid of those high fat and high cholesterol animal foods. This is how we ate, and four more years passed before we moved to Paris.

In France, delighted to be living in a place with a food culture that greatly values fresh, locally grown and hand crafted foods, we continued another four years basically eating as we had done in Ottawa, but with more greens and leafy veggies throughout the year, and more fresh butter, cheese and eggs, still with just as much whole grains. A diet that, according to most natural health experts, aficionados and professionals, was ideal: a diet based on different kinds of whole grains (spelt, kamut, millet and quinoa which was our favourite) served with oil and soya sauce, and different kinds of whole grain breads (wheat, spelt, kamut and rye), toasted and crispy, sometimes dressed with crushed garlic, oil and salt, sometimes with tahini and feta cheese, sometimes with almond or peanut butter, all of these whole grains and breads always so incredibly delicious, and best of all, so we thought, excellently healthy and good for us. Once or twice a week we would buy warm, sometimes steaming, traditional sourdough baguette, super crunchy and crispy on the outside and super moist and chewy on the inside, that we would often have with butter, radishes and salt (and what a treat that was).

We always had with our evening meals large leafy green salads, or grated carrots and beets, or thinly sliced red or green cabbage, accompanied by fresh goat cheese. A couple of times a week we would have eggs. Every day we had fruit, always in accord with the season: cherries came first, then strawberries, then plums, then apricots and peaches, then melons and watermelons, then grapes, and finally apples and pears, which were also here in France our standard fruit during the winter. No refined or commercially made foods of any kind, everything local and organic, no junk food, no sweets, no sugar, unpasteurised honey sometimes, and desserts on very special occasions like birthdays or other celebrations.

Many would think that this was all pretty incredible, fantastically healthy, even. You, readers of this blog, surely know much better than to think that by now. But I think sharing the details of the realisations that were triggered by my witnessing of the birth of the baby lamb and the mother’s eating her own placental tissues, together with the details of this twenty year experience, with explanations of the effects and consequences that I have since understood to have been caused by this apparently excellent, whole, unprocessed food diet, some deficiencies with which I am still struggling to this day, might be of interest and useful for other people who are concerned about what they eat, and are possibly following any one of the large number of different diets promoted for their particular virtues and health benefits over other diets promoted by other people. We will begin this exploration in the next part.

If you think this article could be useful to others, please ‘Like’ and ‘Share’ it.

Living healthy to 160 – insulin and the genetics of longevity

Of the most remarkable discoveries of the last 15 years, discoveries that might well turn out to be the most remarkable of the 21st century, are those of the telomere—a little tail at the end of our DNA whose length tells us how long we have left to live, and of the enzyme telomerase—the specialised protein whose job it is to try to repair the telomeres so that the cells (and we) can live longer and, from an evolutionary perspective, increase the probability that we’ll have more babies. This and other research into the biology of ageing and the details relating to the transcription of DNA, and the expression or suppression of genes is truly amazingly fascinating. I will turn to this in time, but think it would be jumping the gun to do so now.

What is definitely one of the most remarkable discoveries of the 20th century pertains to the hormone insulin. I am not, however, here referring to the fact that its discovery revolutionised medicine by allowing the saving of countless diabetics from highly premature and painful deaths, usually preceded by torturous amputations of their feet or legs and all the of the horror and misery brought on by these seemingly barbaric and radically extreme measures. (And don’t for one second imagine that such amputations are a thing of the past: I know for a fact—heard directly from the mouth of a practicing orthopaedic surgeon—that amputations are the reality of his everyday, performing sometimes two in a single day.) I’m not either, at least this time, talking about insulin as the master metabolic hormone that regulates the storage into cells of nutrients circulating in the bloodstream. What I am referring to as one of the 20th century’s greatest discoveries in regards to insulin is that of its role in regulating the rate of ageing.

Something that is almost as remarkable is that we hardly ever hear or read about this. For me, that’s really strange. But whatever, I’m not going to hypothesise and speculate to come up with an explanation for why this is. Insulin as regulator of the rate of ageing is what we’ll look at in this article.

Why do mice live two years but bats fifty? Why do rats live three years, but squirrels fifteen. Why do some tortoises live hundreds of years? Why do the smallest dogs, like Chihuahuas, live about twenty years, while the largest, like Great Danes, live five to seven years only? And why do we, humans, live around 80 years, rarely making it to 90, and very rarely to 100 years of age? It is this line of questioning that triggered in the late 80’s and early 90’s a geneticist working in evolutionary biology to hypothesise, for the first time, that ageing could be genetically regulated, at least to a certain extent.

It was the discovery and subsequent realisation in evolutionary biology at that time, that a large number of fundamental cellular processes and mechanisms regulated by a variety of genetic expressions were common to widely different organisms. The realisation was that because all animal life must necessarily share a common ancestor, it is not only logical that the most fundamental functions of cells and especially of how genes express themselves under the influence of hormones essential for life could be the same, but that it should be, to a great extent, expected to be that way. And even though these considerations may seem obvious in retrospect, the fact is that there was only one person with this knowledge, asking these questions, and having the means to do something about seeking an answer to some. Cynthia Kenyon, Professor at UCSF, was this person.

The subject was quick to choose: the tiny worm that Kenyon had already been studying for years, C. elegans, was perfect because it is simple but nonetheless a complex animal, and because it has a short natural lifespan of about 30 days. The first step was clearly defined: find at least one long-lived individual. What seems very surprising from our current vantage point it that she couldn’t readily find one: she couldn’t convince anyone to join with her in this endeavour. Everyone was at that time convinced that ageing was something that just happened: things just wore out and deteriorated with use and with time; nothing to do with genes. But how could this be if different species—some very physically similar—are witnessed to have such widely different lifespans? It just had to be genetic at some level, Kenyon thought. Eventually, after a few years of asking around and searching, she found a young PhD student that was up to it, and set out to find a long-lived mutant.

A number of months down the road a long-lived mutant was found and immediately identified as a ‘DAF-2 mutant’. This mutation made the DAF-2 gene—a gene responsible for the function of two kinds of hormone receptors on a cell’s membrane—less active. The next step was to artificially create a population of DAF-2 mutants and see how long they live, statistically speaking, compared to normal C. elegans. It was found that the genetically ‘damaged’ worms, the ones for which they had turned down the expression of the DAF-2 gene, lived twice as long: starting with exactly the same number of worms, it took 70 days for the last one of the mutants to die compared to 30 days in the normal population.

But an additional observation was made: the curve that traced the fraction of worms remaining was stretched by a factor of two from about the start of adulthood for the mutants. They had the same relatively short childhood but then for the remainder of their lives, for every day in the life of the normal worms, the mutants would live two days. The most impressive was that they were really half their chronologically equally aged cousins in all respects: external appearance, level of activity and reproduction.

To make you appreciate this point as much as you should, this observation with respect to not just the lifespan but notably the healthspan of C. elegans would translate in human terms in someone being 80 years old but looking and acting like a 40 year old in the sense that nobody could tell that they were not 40, let alone 80 years old. Just like Aragon in the The Lord of the Rings. This person would be like a 40 year old at 80, like a 60 year old at 120, and like an 80 year old person coming to the end of their life by the time they were 160! Can you even imagine that? Hard isn’t it. But this is exactly what Kenyon and her team were looking at in these experiments with these little worms.

Now they wanted to understand the effect of the DAF-2 gene, or rather, understand the effect of suppressing its expression in the DNA of each cell’s nucleus at different developmental stages. If it was turned off completely, the worms would die: clearly, DAF-2 expression, at least in C. elegans, is essential for life. If it was suppressed immediately after birth (hatching), the little worms would enter the Dauer state in which they don’t eat, don’t grow, don’t reproduce, and basically don’t move either: they just sit and wait. Wait for what? For better times!

This Dauer state is a remarkable evolutionary adaptation seem in some species that allows the individual to survive during periods of severe environmental stress such as lack of food or water, but also high UV radiation or chemical exposure, for example, for long periods of time with respect to their normal lifespan in a very efficient kind of metabolic, physiological and reproductive hibernation. What’s really cool is that inducing worms out of the Dauer state, no matter how long they’ve been in it, they begin to live normally again, moving and eating, but also reproducing. So, in the Dauer state C. elegans literally stops ageing altogether and waits, suspending metabolic activities and physiological functions until conditions for reproduction and life become adequate once again.

celegansfasting

Taken from Worms live longer when they stop eating  (http://www.bbc.co.uk/nature/2790633)

If DAF-2 expression was turned back up to normal, then they moved out of Dauer and resumed their development stages equivalent to childhood, teenage-hood, and then adulthood, but didn’t live any longer as adults. Finally, suppressing DAF-2 expression at the onset of adulthood resulted in the extended lifespan as originally observed. The conclusion was therefore clear: DAF-2 expression is essential for life and necessary for normal and healthy growth and development in immature individuals from birth until they reach maturity, and suppressing DAF-2 expression was only effective at extending both lifespan and healthspan in mature individuals.

Going further, they now wanted to understand how DAF-2 suppression actually worked to extent healthspan: what were the actual mechanisms that made the worms live longer when DAF-2 expression was turned down. For this, Kenyon’s team needed to look at all of C. elegans’s 20000 genes and figure out how they affect each other. (Note that this is also more or less how many genes we have, but C. elegans has only 3 chromosomes and is also hermaphrodite.) The sequencing of the worm’s genome was done in 1998, and what was found after analysis was very interesting:

The DAF-2 gene activates a phosphorylation chain that attaches phosphate groups onto the DAF-16 transcription factor. In normal individuals the DAF-2 gene is expressed normally, the phosphorylation chain works unimpeded, and the DAF-16 transcription factor is inactivated. In the mutants, the DAF-2 gene expression is suppressed, and as a consequence, the DAF-16 transcription factor is not inactivated and instead accumulates in the nucleus. There, DAF-16 encodes what Kenyon’s team showed to be the genetic key to health and longevity they were looking for from the start of this now decade long pursuit: the FOXO gene.

What does FOXO do? It promotes the expression of other genes, at least four other genes: one responsible for manufacturing antioxidants to neutralise free radicals the largest amount of which are produced by the mitochondria as they make energy for the cell; a second responsible for manufacturing ‘chaperons’ whose role as specialised proteins is to transport other proteins and in particular to bring damaged ones to the cell’s garbage collector and recycling facility to promote the replacement of those damaged proteins by new and well-functioning ones; a third responsible for manufacturing antimicrobial molecules that increase the cell’s resistance to bacterial and viral invaders; and the fourth that improves metabolic functions and in particular fat transport (reduce) and utilisation (increase).

It is these four genetically regulated cellular protection and repair mechanisms, the cumulative combined effects of all these increased expressions of antioxidants, chaperons, antimicrobials and metabolic efficiency—all of them at the cellular level—that allow the lucky DAF-2 suppressed mutants to live twice as long twice as healthy. Remarkable!

Now that all the cards about how the long-lived mutants actually live twice as long as expected under normal conditions are laid on the table, and that there is only one detail I left out of the story up to this point, tell me: can you guess what are the two sister hormones to which the cell’s sensitivity through the activity of its receptors for them are controlled by the DAF-2 gene? It’s a trick question because I told you half the answer in the introduction: The DAF-2 gene encodes the hormone receptors for both insulin and the primary form of insuline-like growth factor IGF-1. Surprised? It isn’t surprising, really. In fact, it all makes perfect sense:

Insulin and IGF-1 promote growth; nutrient absorption and cellular growth and reproduction are essential for life and thus common to all living organisms, including the more primitive of them like yeasts; growth in immature individuals is fundamental for health and for ensuring they reach maturity; but growth in adults, in mature individuals, just means ageing, and the more insulin and IGF-1 there is, the faster the rate of cellular damage and deterioration, the more genetic mutations from errors in transcription, the more pronounced the deterioration of the brain and the heart, of the arteries and the veins, of the muscles, the bones and the joints, and obviously, the faster the rate of ageing. Because what is ageing if it is not the word we use to describe the sum total, the multiple negative consequences, the end result of all of these deteriorations in these vital organs and systems but also everywhere else throughout the organism, all of it starting at the cellular level, in the nucleus of every cell.

About the necessity of insulin for normal growth, you should definitely not think that these observations impliy we should stimulate insulin secretion in the young in order to ensure proper growth. Totally not! The body knows exactly when and how much insulin is needed at any given time. In fact, any additional stimulation of insulin promoted by eating simple and starchy carbs actually deregulates the proper balance of hormones that the body is trying to maintain. This deregulation from a sugar laden diet in children is the very reason for many wide spread health problems in our youth most important of which is childhood obesity and the metabolic and physiological stresses this brings on. So, leave it to mother nature to know how to regulate the concentration of insulin in the bloodstream. Do not disrupt the delicate biochemical balance by ingesting refined carbohydrates: it’s the last thing anyone needs for good health and long life.

The first results were so interesting that several other groups joined in this research into the genetics of ageing. Not as much as one would think, but at least a handful of other groups began to apply and expand the techniques to other species. Unsurprisingly, the same effects, although with different magnitudes, were seen in these very different species, from an evolutionary standpoint: fruit flies and mice. In addition, the connection was made with lifespan-extending experiments using calorie-restriction, which have also been carried out on mice and other animals (we’ll look into this another time). And beyond the work around DAF-2, DAF-16 and FOXO, Kenyon’s group investigated other ways to influence lifespan and found two more.

The first was by disabling some of the little worm’s sensory neurones of which there are very few, making it easy to test and determine the influence they have separately and in combinations. They tested smell and taste neurones, found that disabling some would extend lifespan while disabling others didn’t. They also found that disabling different combinations of smell and taste neurones could have nulling effects. The second was playing with the TOR gene expression. For now, however, we will leave it at that.

As the fact that it is rare and relatively hard to come by this work without actually looking for it, there is something else I find very hard to comprehend. In Kenyon’s various lectures on this work, there is usually a mention of the biotech company she founded called Elixir Pharmaceuticals and how they aim to find one or more drugs that can suppress DAF-2 expression in humans without causing negative side-effects in order to extend lifespan and healthspan as was done in C. elegans with genetic manipulation. That’s fine, and does make sense to a certain extent, especially if we can find not chemical drugs but natural plant-derived compounds that have this effect on us.

The thing that doesn’t make sense and that is hard to understand from the naive perspective of the honest scientist looking for the simplest possible solution to a problem of inferring something we don’t know from information that relates to what we want to know: in this case this mean the simplest way to make the best use of this information and apply what we have learnt from these two and half decades of research in a way that we know would be beneficial in promoting a longer and healthier lifespan in humans without risks through the introduction of foreign substances in our body. Because they haven’t, here I offer my attempt to do this.

We have, thanks to Kenyon and others, understood in great detail how lifespan in complex organisms can be, to a great extent, genetically regulated, and which genes, transcription factors and mechanisms are involved in the process of regulating the rate of ageing in conjunction with the propensity for developing age-related degenerative diseases. In the final analysis, the main players are the DAF-2 gene that tunes up or down the sensitivity of insulin and IGF-1 receptors, the DAF-16 transcription factor that encodes the FOXO gene but is made inactive by the expression of DAF-2, and the star FOXO longevity gene that promotes the expression other genes responsible for stimulating the cell’s most powerful protection and repair mechanisms.

We have, from many decades of research on calorie-restriction and fasting in animals including humans (and which we’ll explore elsewhere), understood that this is an extremely effective way to extent both lifespan and healthspan and basically eliminate the occurrence of age-related degenerative diseases by greatly increase resistance to health disorders of all kinds. Some key observations on calorie-restricted animals include their very low blood levels of sugar, insulin and IGF-1, high metabolic efficiency and ability to utilise fat demonstrated by low blood levels of triglycerides, and their remarkably younger appearance with increased energy and activity levels.

And finally, we have, from more than a century of observations and research, concluded that diabetics, whose condition is characterised by very high levels of blood glucose, insulin and triglycerides, are plagued by a several-fold increase in rates of cancer, stroke, heart disease, kidney disease, arthritis, Alzheimer’s and dementia, basically all the age-related degenerative diseases known to us, and in addition, also a several fold increase in their rate of ageing based on the spectrum of blood markers used for this purpose, their appearance, but also on the length of their telomeres.

Is it not, therefore, obvious from these observations that high blood sugar, high insulin and high triglycerides are hallmarks of accelerated ageing and a propensity for degenerative diseases, while low blood sugar, low insulin and low triglycerides are instead necessarily related to extended lifespan, extended healthspan and increased resistance to all disease conditions including those categorised as degenerative, and this, independently of the actual mechanisms involved?

Is it not, therefore, plausible from these observations that the genetic mechanisms relating to the function of the DAF-2 gene, DAF-16 transcription factor and FOXO gene in conferring to the DAF-2 mutants twice as long a life can, in fact, be activated and enhanced epigenetically by creating an environment in the organism that is conducive to it: simply by keeping blood sugar, insulin and triglycerides as low as possible? In other words, isn’t it plausible from these observations that by manipulating the biochemistry to ensure that blood sugar, insulin and triglycerides are throughout the day and night as low as possible depending on the organisms requirements, that this will actually translate into the activation of the FOXO gene to enhance protection and repair at the cellular level and thus extend lifespan and healthspan?

And what is, not only the easiest and simplest, but also the most effective way to do this? It is to eliminate insulin-stimulating carbohydrates—sugars and starches—from the diet completely. This, within 24-48 hours, will allow sugar levels to drop to a functional minimum. The low blood sugar will allow the pancreas to reduce production and insulin levels to drop bit by bit. Lowered insulin will eventually allow the cells to start using the fat circulating in the blood, and in time, increase in efficiency, thereby dropping triglyceride levels lower and lower.

Why is it you think that Kenyon never mentions this anywhere? Do you think that this has simply not occurred to her? I honestly don’t know. But if there is a single thing to remember it is this: insulin is necessary for life; in the immature individual, insulin regulates growth; in the mature individual, insulin regulates the rate of ageing and the propensity for degenerative diseases. Hence, if you are a mature individual, and by this I mean full grown, and if you want to live long and healthy, the very first thing you need to do is to keep the concentration of insulin circulating in your blood as low as possible. Everything else that we can do to extend healthspan and lifespan is secondary to this.

If you think this article could be useful to others, please ‘Like’ and ‘Share’ it.

Two short fat-loss tales

– You look like you’ve lost some weight.
– Yes, I have! I’ve lost 12 kg in 4 months. You remember, a year ago, I told you I would do my own diet, and I did!
– That’s great, congratulations!
– You know what I did? I stopped eating junk. I didn’t do anything else. I stopped eating chocolate bars and candy; cakes, cookies and ice cream; chips and fried foods, and that’s it. I eat everything: anything that is a whole food, and I do have bread and potatoes, rice and pasta, as well as cheese and fruit. I didn’t do anything crazy or radical, I just eliminated junk food from my diet.
– That’s really good. I’m happy for you. Keep it up!

This is how went a short conversation I had recently with a colleague who, a couple of years ago, was one of the 25 people who attended the talk I gave at ESAC: Water, sugar, protein and fat. It could be (I’d like to imagine) that the talk was like a little seed in her mind that was what eventually grew into enough of a motivation to start what she had been doing for a few months already, making her feel really great about it, as anyone would, of course. And I’m really happy for her, and also very happy to possibly having been a little positive influence somewhere along the line.

Another colleague stopped by my office in the spring to ask about the fitness club (a club to encourage people to exercise by subsidising part of the monthly membership to a great sports club close to where we work for which I was president for several years until a month ago or so). He mentioned in passing that he wanted to start doing sports in order to lose weight. Naturally, I immediately said that exercising wasn’t really the key to fat-loss. He was surprised, as most people are when they hear this. Being interested and inquisitive about this point (he works as a scientist, after all), I gave him a 10-minute summary of the biochemistry of fat loss, and he left very motivated to start on his fat-loss programme.

About one month later we crossed paths on the main road in front of the canteen. He looked much thinner: he actually looked quite trim considering that as little as four weeks before he not only looked but was definitely quite chubby.

– Things are going well, I see! You look like you’ve lost a lot of weight already.
– Yes, I’ve lost 10 kg. Now, after the first four weeks, I’ve started to eat carbs again, but I’m eating 1500 calories and exercising every day. I started eating some complex carbs because I need energy.

I masked my internal cringing, and just said “well, you are much leaner than you were. Good job and keep it up!” But I thought: What in the world!?! How did he come to think like this after I explained to him how fat loss works, and which he seemed to understand? The thing is, he did cut out all carbs for four weeks—there’s no way in the world he would have lost this much fat any other way—but for whatever reason, he now thought he should start again because he was exercising every day and therefore “needed energy”. He really didn’t understand the most important points I had tried to relate in that chat we had in my office. I am, in any case, very happy for him as well, because it is always better to be leaner than fatter, especially considering that a lot of the excess fat accumulating in our abdominal cavity is stuffed in between and all around our vital and digestive organs, putting constant pressure on everything in there, and that’s really bad.

Now, I would like to think that all of you readers of this blog already know what I want to point out and explain in regards to these two short fat-loss tales. Whether you do or not, I thought it was a good occasion to review the essentials of fat-loss in a quick and focused but more informal style than in other articles I have written. You are more than welcome to take a few minutes and try to guess what I’m about to explain about these two cases before moving your eye gaze down onto the first line of the next paragraph.

Why did the first colleague I talked about lose so much weight? Is it because she started exercising? No. She never exercised and still doesn’t. Is it because she starved herself on a low-calorie diet Weight Watchers style? No. She hasn’t been hungry because she hasn’t tried to eat a lot less, and has three meals a day without paying close attention to how much and is certainly not counting calories. Is it even because she stopped eating “junk food”? No, it’s not. The reason why she has lost this weight seemingly so easily is only because she markedly decreased the amount of sugar she ate, which immediately translated in lower blood sugar levels throughout the day and night, which in turn translated into lower insulin levels also throughout the day and night. As insulin drops, fat-burning starts.

Will she continue to lose her fat reserves indefinitely at this rate until there are none left? No, she won’t: fat utilisation, and therefore fat-loss rate, is inversely proportional to insulin levels. So, the lower the blood sugar, the lower the insulin, and the lower the insulin, the faster the fat-loss rate. Because she still eats sugar in the form of starches, the sugar/insulin concentration will only sometimes drop low enough for fat-burning to start, and will not drop very low and stay there to allow the metabolism to fully adapt and settle into a stable and more or less constant fat-burning mode. She will remain in intermittent fat-burning and sugar-burning. Because her fat reserves are at this stage still very large (from the organism’s perspective they are still effectively infinite), the relatively lower blood sugar for periods of several hours will prompt the body to continue to let go of these excessive fat reserves relatively easily until a steady state is reached and fat-loss stops. At that point she will still have plenty of excess body fat, but will be unable to lose any more without dropping insulin levels lower.

Of course, eliminating junk food—mostly commercial sweets and fried stuff—and feeding ourselves with actual food, no matter what it is, makes a huge difference. This is definitely the very first step in any change of diet towards better health. That’s obviously not something worth debating or even discussing. The point is that no matter what the changes in the diet, the biochemistry of fat loss is always the same, and it is the same for everyone. Everything is about insulin for the very simple reason that it is insulin that shuttles nutrients from the bloodstream into cells. This is true for sugar, protein and fat. But insulin is released by the pancreas primarily in response to the presence of sugar in the blood (but also in the absence of stress hormones which block insulin’s action to retain the sugar in circulation as long as the “potential threat” remains). The gist of it is: high insulin—nutrient storage, low insulin—nutrient release; high insulin—fat storage, low insulin—fat-burning.

What about the second colleague exercising and eating only 1500 calories that include starches and some fruit? He will continue to lose fat until the body determines that the bulk of the really excessive fat reserves have been spent, and then will stop. This will happen probably somewhere around 20% body-fat for guys and 30% for women, but will depend on age, exercise level, food, etc. So, he will get lean enough to appear slim, feel light, and also feel pretty good about himself every time someone compliments him on his figure. The more serious problem for him is that exercise, and especially the aerobic exercise like running that he is does to “burn more calories”, breaks down muscle quite quickly but it is not rebuilt.

The low calorie intake places the metabolism in calorie-deficit given that an average man needs about 1500 calories just for basic metabolic functions. This means that all additional calorie requirements have to come from somewhere other than the food that is eaten. Ideally, of course, these would come from fat reserves of which there are plenty; that’s the idea of the low-calorie dieter. But this will and can only happen if insulin levels are at rock bottom: I mean 1–3 units. Otherwise, the body will cannibalise its muscles because it can most easily get the easiest-burning cellular fuel it needs by converting protein into glucose. And the result? Over time he’ll lose most of his muscle, will retain that 15-20% fat, and will inevitably acquire the skinny-fat look. You know what I mean: the look of a slow, 40-50 year-old long-distance runner on a typical high-carb “runner’s diet” who looks skinny but giggly, with barely any visible muscle and no definition at all: muscle tissue broken down and not rebuilt; fat reserves not used because insulin is too high.

Had you guessed all that? Do you now understand how to burn fat without hunger and without losing muscle? Drop sugar levels, drop insulin levels: lose the fat reserves, keep the muscle. Eat fibrous veggies, lots of unprocessed fats and enough clean protein; don’t eat any sugar or starch. Very simple.

And here’s a teaser for a future series: if you want to build muscle and maximally slow down ageing, you will—in addition to this kind of shift in diet—also start lifting weights: squats and dead lifts, bench press and overhead standing press, bent-over rows, dips and pull-ups; and the heavier and more strenuous the better!

But if you’ve never done any of that, don’t go out and start lifting as much as you can right away because you’ll hurt yourself: you have to start slow, and have impeccable form and technique before starting to put on more weight. However, the fact is that there is really nothing more effective than heavy weight lifting to correct metabolic imbalances, postural problems, muscle and joint weaknesses; to burn fat, build muscle, and increase bone density; and totally rejuvenate the body and restore a incredibly youthful hormonal profile. The most amazing thing is that this is true for men and women of any age. I hope to find the time and write about this in the not-so-distant future.

If you think this article could be useful to others, please ‘Like’ and ‘Share’ it.

Treating arthritis II: cleansing, nourishing and rebuilding

Preventing arthritis is easy. Unfortunately, everything everyone does, or almost, promotes arthritis. But not just arthritis, all inflammatory degenerative conditions. The amazing thing is that what must be done to prevent any of them is quite well known. We have covered a lot of material relating to this already, and it was made clear at the start of Treating arthritis I, that natural healing, even when motivated by the healing of a particular condition, is done through healing the entire organism—all cells, all tissues, all organs, all parts—all at once. Therefore, we could just as well entitle this article “treating arthritis and all other inflammatory degenerative disease conditions” because the approach is fundamentally always the same.

Treating arthritis after it has already developed is not as easy as preventing it, but the extent to which it can be reversed and cured depends firstly on our own dedication and determination, and secondly on the state of the body and amount of damage it has sustained. The first article on arthritis was posted a while back. Its writing was motivated by my wish to help a friend who suffers from a highly debilitating form of arthritis for which conventional approaches are mostly inadequate—as inadequate as they are for all other degenerative chronic conditions.

It is useful for me to know that even if these efforts of were in vain in the sense that they were not acknowledged and didn’t motivate in them to make the recommended changes in lifestyle and diet, the article must have made some difference to some people because it has at this point been viewed more than 4600 times, and is the most viewed of all the posts on the blog after the Welcome page. If you are among the millions of people who suffer from arthritis, and also happens to be one of those who read Treating arthritis I, I hope you found it useful, and you are most welcome to let me and every other reader know how.

There is an obvious difficulty in overcoming any state of disease, especially one like arthritis. It is that everything about our success depends on our efforts to foster and nurture the conditions under which the organism can heal and repair itself. This is the only way to regain health. I want to emphasise this more explicitly:

It is only by creating, fostering and maintaining the biochemical, hormonal and physiological conditions under which the organism has the ability to clean, repair and rebuild its cells, tissues and organs that disease conditions—no matter what they are—can be prevented, overcome, reversed and recovered from. What we are required to do is provide the organism what it needs to do this.

The fundamental elements we concentrated on in the first part were: hydration, alkalisation, and magnesium. As was underlined, these are essential for everyone, but primordial for arthritis relief. The detailed recommendations were intended to help establish good habits. Their essence should be understood as follows.

what-arthritis-pain-feels-like-722x406

Illustration of painful, inflamed, arthritic joints. (Image taken from Everyday Health)

Every day, from the moment you get out of bed, your primary concern should be to hydrate and alkalise. This is particularly important in the morning and the first part of the day. There is a natural daily cycle governed by the circadian rhythm which controls all processes in the organism by a delicate balance of a vast number of different hormones. A good example relating to the hydration-dehydration cycle, is that the hormone calcitonin whose role is to put calcium from the bloodstream into bones and teeth, is active at night as dehydration sets in: as the water content of the blood decreases, the kidneys release renin and angiotensin, calcitonin is activated, and can thus do its work for fixing calcium where it is needed, subject to adequate amounts of the all-important fat-soluble vitamins D and K2. There are surely many more hormonal processes that depend on the diurnal cycle than those we currently know of. The point to remember is that we have to make hydration and alkalisation a priority in our life, and repeat this every day, while allowing dehydration during the night by typically having our last drink of water between 19 and 20 hours and nothing else until the morning.

Hydration and alkalisation are most effectively done when there is no food in the stomach, and both depend critically on maintaining a balanced intake of water and unrefined salt. An easy way to keep track of both and ensure optimal balance, is to prepare capsules filled with unrefined sea salt, taking one capsule for every half liter of water tea or green juice. This is particularly useful when doing a cleanse. In normal circumstances, it can also easily be achieved by having watery veggies like cucumber, celery or kohlrabi with liberal amounts of salt a couple of times a day. It is ideal to finish drinking about 30-45 minute before eating and not drink for two to three hours after. This leads to a natural rhythm of drinking, waiting, eating, waiting, and repeating this pattern throughout the day.

As this is so, it is easiest to hydrate and alkalise thoroughly each day by adopting a regime based on having only one big meal in the late afternoon or early evening, leaving the rest of the day before that to focus on these crucial aspects of our optimal health without the constraints of the timing surrounding eating. Snacking on raw veggies and salt is perfect and can be done at any time regardless of drinking, because it is also a kind of drinking: watery veggies are basically water with minerals, enzymes, phytonutrients and some fibre. Intermittent fasting, as is called, has many metabolic and physiological benefits not least of which is natural detoxification.

We have looked at some of the key aspects of this practice in The crux of the intermittent fasting, and I plan to deepen this investigation in the future, but maybe the most useful consequence of it, which should also come across as a rather obvious, is that if the body is getting food of any kind that requires processing, then it will immediately engage in doing just that: processing it to extract what it can from it.

Food processing is prioritised and mobilises much of the body’s energy and resources: blood supply (directed to the stomach), secretions from the digestive organs (acid and enzymes from the stomach; insulin, bicarbonate and more digestive enzymes from the pancreas; and bile produced by the liver and stored in the gallbladder), active transport across the intestinal wall into the bloodstream, increased workload on kidneys and liver in filtering metabolic wastes out of the blood, and although you don’t feel it, you can be sure that this does indeed require a lot of energy and bodily resources.

Allowing the body to rest from all this food processing related physiological activity leaves all this energy for other tasks which generally fall in the category of “clean and repair”. This is the natural detoxification that the body desperately needs to engage in as often and regularly as possible but unfortunately cannot because we are, from the time we wake up to the time we go to bed, almost constantly eating. As soon as we take the foot off the gas pedal and give the system a much-needed break from food processing, the organism immediately begins to clean and repair itself. This is why fasting is so good.

Now, if you, in addition to that, provide the organism with a supply of vital nutrients—enzymes, vitamins, minerals—in a form that requires no digestion and is immediately absorbable from the intestines into the bloodstream in the form of vegetable juices, this becomes an amazing way to bring about self-healing in what will indeed look like a most miraculous manner depending on how sick we are at the onset. This is what happens during a juice fast or cleanse, and although fasting has been practiced for centuries, and juice fasting for many decades, both with awe-inspiring results, one recent and vocal advocate of juicing cleanses for healing is the Englishman Jason Vale who runs the Juicy Oasis retreat and healing centre in Portugal (see Superjuice Me on FMTV).

Arthritis sufferers would do extremely well to consider doing such a juice fast as well as adopting intermittent fasting as a long-term daily practice. These measures—in and of themselves—could resolve the problem permanently in a relatively brief period of time.

The importance of magnesium was also emphasised in Treating arthritis I. The best is to have baths with one cup of nigari and one cup of baking soda at least once a week (a couple of times is great, and in some circumstances you may want or need to have them every other day). We should soak the whole body for 45–60 minutes. Magnesium oil, a saturated solution of nigari in water, is also very effective. Putting it on the skin of the arms, upper back and neck, chest and belly, legs and bum, avoiding sensitive skin of the armpits and genital area, and leaving it at least 30 minutes before showering. It can work wonders to loosen tight, achy or cramping muscles, and will often do this quickly from the first application. It doesn’t need to be done every day, but it can for several months without risking overwhelming the system with too much magnesium. Oral supplementation with liposomal (fat-bound) magnesium is also a very good idea.

Once we have understood the importance of these elements of health, healing and recovery that are hydration, alkalisation, magnesium, juicing green vegetables and intermittent fasting, and incorporated them into our life as fundamental pillars of optimal health, then we can and must turn to the question of what to eat when we do eat.

When we consider what to eat from the perspective of eating to most effectively promote health, the considerations can be very different from what they might be were we to take any other point of view as to our primary motivation. For optimal health, the first and foremost important consideration is the old and well-known principle first do no harm. This means what it says, but more explicitly means to not eat anything that has or may have detrimental effects on the organism. Using “has” implies negative effects have been identified and demonstrated to a lesser or greater extent, whereas “may have” means that even though there may be little, inconclusive or no evidence, there are nevertheless reasons to be skeptical or at least cautious about its safety or health benefits. Simple examples include cigarette smoke that is well established to have multiple negative impacts on our health, and industrial pesticides demonstrated to be endocrine disruptors or neurotoxic: a new brand of cigarettes or a new yet untested agricultural pesticide should therefore also be considered as potentially harmful. This is just common sense.

Following this principle encourages us to eliminate industrial chemicals and additives from our food and drink, but also from our cleaning and body care products. This can sound as an obvious and simple first step, but it is not so easy nor so simple without considerable care and attention to detail. Moreover, it also implies, right from the start, no industrially processed products of any kind, and that is a major step for most people given the state of affairs and average dietary regime of the bulk of the population in industrialised countries.

Assuming you are reading this because you are already on the lookout for better ways of doing things, as well as already feeding yourself with real food, this is not such a big deal. And in practice, it means this: buy and eat only whole organically grown or raised food, use only the simplest and most benign organic cleaning and body care products, drink the highest quality filtered or natural spring or mineral water that is certified to be free of known major and minor pollutants, and take only the highest quality supplements. Doing only this ensures an already excellent base for a healthy lifestyle, and it is already enough to avoid and prevent a lot of potential health disorders.

It is, however, not enough if our goal it to be optimally healthy, never have any health disorders at all, and live strong and vibrant to 100, 120 or 140 years of age. It is, also, not enough if we are trying to stop progression, reverse already existing damage, and eventually recover from our own arthritic condition that may have been causing us pain for years or decades. In either case, we need to go further.

The statement in the opening paragraph about the universality of the natural healing approach to treatment and prevention of disease conditions is here both appropriate and necessary to emphasise:

the most fundamental characteristic of but also driver in progressively worsening arthritis symptoms and degeneration is chronic systemic inflammation;

the most fundamental characteristic of but also driver in progressively worsening cardiovascular heart disease symptoms and degeneration is chronic systemic inflammation;

the most fundamental characteristic of but also driver in progressively worsening cardiovascular brain disease symptoms and degeneration is chronic systemic inflammation;

the most fundamental characteristic of but also driver in progressively worsening Alzheimer’s disease symptoms and degeneration is chronic systemic inflammation;

the most fundamental characteristic of but also driver in progressively worsening multiple sclerosis symptoms and degeneration is chronic systemic inflammation;

the most fundamental characteristic of but also driver in progressively worsening Crohn’s disease symptoms and degeneration is chronic systemic inflammation;

and, of course, the most fundamental characteristic of but also driver in progressively worsening type II diabetes symptoms and degeneration is also chronic systemic inflammation,

even if we know that the root cause of this diabetes is chronically elevated glucose and insulin levels, that this leads to systemic inflammation, which in turn leads to the pathological symptoms and degeneration, something that is underlined by the fact that diabetics suffer all other chronic diseases listed above 200-400% more than non-diabetics.

This was a forceful, repetitive, heavy-handed way to express and highlight this fundamental characteristic that is shared by so many disease conditions. But it is, I think objectively, the most important point to have in mind when our intention is to really understand health and to be ourselves, at all levels, an expression and embodiment of health. Because whether it is inflammation in the joints as in arthritis, in the arteries supplying the heart or brain as in cardiovascular disease, in the brain itself as in Alzheimer’s disease, in the nerves throughout the body as in multiple sclerosis, in the lining of the gut as in Crohn’s disease, or basically everywhere in the body as for diabetes, this inflammation—in all cases—is chronic and systemic. Hence, it is this which must be addressed and corrected, and it is addressed and corrected in exactly the same way in every case.

Taking into account differences and thus tuning the treatment, especially in what concerns reversing and repairing existing damage, is important. But it is definitely secondary with respect to the root cause of degeneration that is systemic inflammation. And even these differences whose importance varies depending on the specificity of the condition we aim to address, all of them—when working with natural, nutrition-based medicine—are useful and health-promoting for all conditions: none are detrimental to the treatment of any other specific disease.

For example, supplementing with organic silicic acid, collagen, vitamin C, and vitamin D is essential for repairing and rebuilding cartilage and soft tissues, and thus essential in the treatment of arthritis. It is, however, greatly beneficial for everyone to supplement with these micronutrients because all will benefit from it. It is essential to supplement with and maintain very high levels of vitamin B12 (>1200 pg/ml) when treating multiple sclerosis or Parkinson’s disease, but it is excellent for everyone to do the same. It is essential to supplement with L-Carnosine when treating Crohn’s disease because it is particularly useful for healing the lining of the gut. But it is also very beneficial for everybody to take because it helps to stop and repair the damage caused by glycation, which affects everyone to a greater or lesser extent depending on circulating glucose and insulin concentrations.

And thus, the first principle is to eliminate from our life what causes inflammation: everything that triggers an inflammatory reaction in the body. This obviously includes all allergens which, even if there are some well-known foods that have been recognised as causing allergic reactions, mild or severe, in a large fraction of the population, and could, therefore, be eliminated from our diet directly in order to minimise unnecessary exposure to potentially harmful substances, it is nevertheless ultimately an individual assessment and testing of food intolerance that is needed.

The foods most likely to cause an inflammatory immune system response are gluten-containing grain products and animal milk products. Estimates of intolerance for these two classes of foods—grains and dairy—range between 50 and 75% in most countries, although evolutionary adaptations can have an important effect. Good examples are the indigenous Swiss mountain dwellers and the African nomadic tribe called Masai, who, by consuming most of their daily calories from milk and milk products for thousands of years, have developed the genetic adaptations for the immune system to tolerate the proteins in milk that cause mild to severe allergic reaction in close to 75% of the world’s population, with the most extreme proportions of 90-95\% in the Chinese and other Asian populations that have never, throughout their history, consumed milk products.

The other two classes of foods that are established as inflammatory—highly inflammatory—even if they rarely cause intolerance or allergic reactions, are insulin-stimulating carbohydrates and omega-6 fats. In the case of these substances, it is not inflammation triggered by a reaction to them of the immune system. Rather, they themselves trigger inflammatory biochemical pathways: several hundred inflammatory pathways! These foods should therefore be eliminated from the diet: all simple and starchy carbohydrates, and all vegetable oils. Nuts and seeds, which contain omega-6 oils, can be had whole in small quantities. Olive oil is mono-unsaturated and is the best vegetable oil to use for salads. No omega-6 rich vegetable oil should be used.

I don’t think it’s necessary nor useful to discuss the inflammatory effects of industrial chemicals because we already know that they only cause harm and should be eliminated from our food supply, avoided at all costs in all their other forms by everyone who is even superficially concerned with their health.

This is our first conclusion: to minimise inflammation, it is essential to eliminate inflammatory foods; and the most inflammatory classes of foods are dairy, grains, insulin-stimulating carbohydrates and omega-6 oils. To overcome or prevent inflammatory disease conditions, arthritis but also all others, we have to stop eating these foods. It is as simple as that. And although it is true that we could potentially supplement with adequate types and amounts of enzymes to try to ensure that all types of proteins found in these foods are actually broken down properly during digestion in order to avoid triggering an immune response, it does seem silly to eat or drink something that we know cannot be metabolised correctly and which is, for this reason, harmful to the organism, but still try to mitigate the harm it causes by taking a supplement of those enzymes needed to digest it that do exist even if our body’s genetic and evolutionary makeup doesn’t produce. This reflection applies to dairy and grain proteins to which we are intolerant. It doesn’t apply to insulin-stimulating carbohydrates or omega-6 fats, because these seldom cause allergic reactions in people, but are nevertheless universally inflammatory.

The second principle is to consume anti-inflammatory foods. It should not be a surprise to find out that the most anti-inflammatory foods (think of them as soothing to the body), also tend to be the most alkalising: raw, green, chlorophyl-rich plant foods, and especially green vegetable juices. The most anti-inflammatory and anti-oxidant fat is the miraculously beneficial, highly saturated (96%), and medium chain triglyceride-rich (50%) coconut oil. Hence, without any additional considerations, we already know that an optimally anti-inflammatory and healing diet should be based on mostly raw vegetables and salads, in particular green ones, green juices, and lots of coconut oil from all coconut products.

Also not surprisingly, we can have as much of these nutrient-rich foods as we want, and the more the better. This, it turns out, is an extremely useful selection criterion to determine the level to which something can be good or bad: how much of it we can eat, and what are the consequences, if any, of having increasingly larger quantities; is there an upper limit in the sense that above a certain amount we can expect negative consequences, or is there only a lower limit below which therapeutic value is not noticeable? For what concerns green juices, greens and coconut oil, I would say that there are only lower limits to the minimum we should all intake in order to be perfectly healthy, and no upper limits within what can be considered reasonable through the body’s auto-regulation mechanisms of satiety and digestive function.

For instance, we can drink a 250 or 500 ml of green juice, and that’s great. We can drink 1000 ml and that’s much better. We can drink two or three litres of green juice per day, and that is truly amazingly therapeutic, something that would be done during a juice cleanse. For coconut oil and milk, we can have one or two tablespoons per day, and that’s really good (apparently enough to slow down cerebral degeneration). We can have five to seven tablespoons per day, and that’s far better (apparently enough to reverse early stage dementia and Alzheimer’s). We can have as much as 200 or 300 ml (between 13 and 20 tbsp) of oil per day, and that’s better still. In the case of coconut oil and milk, eating such large quantities amounts to a lot of calories, all from fat which makes us feel really full and not willing to eat anything. This is the body’s natural hormonal messaging system to prevent over-eating and it works perfectly well in this case. It also works well for protein. Only for sugars and starches does it not work so well because we evolved having very few carbohydrates and thus didn’t have to develop the mechanism to avoid overeating them—what pretty much the whole world is doing nowadays.

Most nuts and seeds can be considered as superfoods because of they are very concentrated sources of minerals, antioxidants, unique phytonutrients, vitamins, as well as fat and protein. Because they are seeds, they also have anti-nutrient—phytates and enzyme inhibitors—without which they would not keep for months on end as they do, and would spoil much more quickly. These are not as strong as they are in cereal grains, which have can keep for thousands of years, as they have in some pyramids, and then sprout after soaking in water for a while. This is nature’s very clever way to ensure dry seeds retain the nutrients needed to grow the plant when the conditions are suitable. But it implies that we must do something to them before we can consume them and know that they are wholly beneficial and health-promoting rather than only partially so.

The solution is simple: soak the dry seeds or nuts in water for 24 hours to hydrate them and activate the biological mechanisms responsible for sprouting—to get the seed ready to produce a new plant by making inactive the enzyme inhibitors and phytates—and making all of its nutrients fully available. Soaked nuts and seeds can definitely be eaten hydrated, and are much more filling that way because they hold as much water as their dry weight (they double in weight and volume when fully hydrated), but they can also be dehydrated after having soaked for 24 hours, and be preserved for much longer than the couple of days they can in the fridge before going bad when hydrated. This is what I do at home: 24 hours of soaking with rinsing and changing of the water a couple of times in between, and 24-36 hours of drying in the dehydrator at 45 C to keep all enzymes alive.

Roasting or otherwise heating the nut or seed also neutralises the anti nutrients, but this also destroys the enzymes, making it a dead food that will require the pancreas to produce the necessary enzymes for digestion, as well as cause digestive stress and acidification. Nonetheless, roasted nuts are nutritious and delicious, and thus great to have once in a while. Either way, sprouted or not, nuts and seeds are by their nature nutrient-rich concentrated food and should generally only be had in relatively small quantities (a handful or two). Doing this will also prevent excessive intake of omega-6 fats that make up about 50% of their weight, even if whole nuts and seeds have their own anti-oxidants that give additional protection from free-radicals in the body.

Having a somewhat different status as food, but being naturally most anti-inflammatory, are the trio of ginger, turmeric and garlic. Some may have difficulty digesting garlic (as is the case with onions as well), but ginger and turmeric are generally very easy to digest and actually digestive aids. It is important in the treatment of arthritis to consume them often, even daily, and in liberal amounts. Ginger is very easy to have in relatively large quantity by cold press juicing it in your daily green juice (that’s what we do), which guarantees you a good therapeutic amount on a daily basis. For turmeric, it is also possibly to find it fresh in some places, but it stains everything that it comes in contact with. Mostly for this reason, we take it in capsules, where it can even be concentrated further to be more potent still. The beneficial compounds in turmeric are most effectively absorbed when taken with plenty of fat (coconut fat is perfect).

Animal protein other than from dairy—eggs, meat and fish—is important for the body but also highly acidifying and therefore inflammatory. In addition, the proteins need to be completely broken down first by the acidic gastric juices in the stomach and then by the digestive enzymes in the intestines in order for the amino acids of which they are made to be available to the brain and other organs, but also prevent partially digested proteins from finding their way into the bloodstream and causing additional inflammatory immune responses.

Therefore, we have to eat only small quantities of the highest quality grass-fed or wild caught animal products, give the organism plenty of time to cleanse the metabolic byproducts of their digestion, and, I recommend, supplement with digestive enzymes when eating animal foods. In fact, I recommend taking digestive enzymes whenever you eat cooked foods: we do not want to get anywhere close to exhausting the pancreas’ enzyme-producing potential, because enzymes are far more important for all other molecular repair and rebuild processes than they are for digesting cooked food, and we need to keep them for these purposes if we aim to live healthy for a long time.

This is our second conclusion: to minimise inflammation and maximise repairing and rebuilding of damaged tissues, it is essential to consume the most powerfully anti-inflammatory, nutrient-dense and anti-oxidant foods. The diet should therefore be mostly raw, primarily green vegetables, green juices, special anti-inflammatory foods such as ginger, turmeric and garlic, unlimited amounts of coconut products rich in coconut oil, some sprouted nuts and seeds, and small amounts of clean animal flesh products accompanied with plenty of time for metabolic cleansing on a continual basis. The supplements most important in treating and reversing arthritis are organic silica, collagen complex (Reverse Aging), whole food vitamin C (from The Synergy Company), magnesium (L-Threonate; both from Mercola), B12 (Thorne), the fat soluble vitamins A-D-K (DaVinci), turmeric extract (Organic India and Gaia Herbs), niacinamide (Thorne), and the universally needed but universally deficient iodine (in Lugol’s solution). In addition, it may be really beneficial to take high doses (50000 IU/day) of vitamin D3 for at least three and maybe up to six months or more, in order to set the body on its course to intensive healing and recovery from years of arthritic degeneration. This has been found to be very effective in some people. Supplementing with proteolytic enzymes is also very important to accelerate healing and repair of damaged tissues.

Incorporating these principles and specific recommendations into one’s life, not as a special diet, but as a comprehensive way of taking care of this amazing organism that is the human body mind, will not only treat, reverse and cure arthritis to the greatest extent, and maybe even completely depending on the level of degeneration, but will do the same for all inflammatory conditions, which underlie all degenerative diseases. In addition, the immune system will grow to be so strong that no infectious diseases will be able to take hold or develop within your body: never get a cold, never get a flu, never catch anything at all.

Finally, there are two crucially important factors which are not related to diet, and that in many ways can overshadow all other efforts to heal and remain in optimal health: lack of sleep and psychological/emotional stress. They are more than important: they are foundational. Without good sleep and minimal stress it is impossible to become and remain vibrantly healthy, no matter what else we do or don’t do.

This shouldn’t be understood to mean that if we don’t sleep well or are overstressed there is no point doing anything else. On the contrary! It is all that much more important to do everything else we can. However, it means that if we are already doing everything else, then without correcting the conditions causing us stress and preventing us to get enough restful sleep, we will never reach our optimal health potential.

Having said that, you can be sure that they go hand in hand: optimal nutrition and biochemistry promote less stress and better sleep; better sleep and less stress promote more balanced biochemistry, digestion, cleansing, and cellular rebuilding and repairing. They are the two sides of the same coin, one that is measurelessly priceless: optimal health.

If you enjoyed this article, please Like and share it to help other people.

Intensive natural healing

It is always very difficult to find out what’s wrong, to find out what’s causing our health problems, to find out what is the reason for the stroke or the heart attack we just had, the diabetes or the cancer we were just diagnosed with. It is always very difficult as long as we think of the body in terms of a collection of separate parts pieced together; as long as we think that it is possible for the arteries supplying the brain or the heart to have a pathology that is not shared by every other organ and tissue; as long as we think that it is possible for the pancreas, the prostate or the mammary glands of the breasts to be defective in their function independently of every other cell throughout the body. The moment we see this, we recognise the absurdity of this point of view and the obviousness of the inter-relation of every cell to every other cell, tissue, organ and system.

There is only one whole body mind, and everything that happens to it affects everything else that takes place within it.

Looking at things from this new perspective, there are always only two possible alternatives: healthy or diseased, ranging from one to the other on a continuous scale with every possible point in between along the line. From this perspective, every medical intervention or treatment that is not intended to correct or remedy something acute—to fix a broken bone, to save someone whose kidneys or liver just failed, to stitch up a wound to prevent the loss of too much blood—but instead attempting to address a chronic disease condition—treating heart disease, diabetes, cancer, arthritis, Alzheimer’s, etc—is bound to fail.

The failure comes from the misunderstanding that stems from the misguided premise that views the body as a collection of parts working to specific ends more or less independently of one another. If we are to ever overcome our health problems and thrive throughout a long and happy life, it is this basic premise—this misguided and erroneous premise—that must be thrown out and replaced by the clear understanding that there is only one whole body mind, and that everything in it affects and is affected by everything else.

We are sometimes, maybe most often, faced with a major health issue that is acute because it is an end point to a degenerative disease condition that has been developing over decades throughout our entire life. Stroke and heart attack are good examples. Sometimes, maybe most often, it is these events that shake us up enough to move us into action, and if we have the luck to have been exposed to sensible information, we can have the chance to begin anew and change the course of the rest of our life, steering it towards recovery and optimal health.

When an event of this kind happens—when we have a stroke or heart attack—we must act fast to recover as quickly as possible and reduce as much as we can the possibility of having another one within weeks or months, something that could easily be fatal. The fact is that this is usually quite likely to happen, and it’s therefore important to take it to heart.

How can we take the most important and extreme measures to reverse this course of progressive degeneration and set ourselves on the course to recovery as quickly as we can? What would I suggest should be done with the greatest sense of urgency based on the understanding that it is our life that is at stake? What are the most important and effective ways to help the body heal and repair itself?

Cleanse, detoxify, heal the gut because everything that circulates in the body comes and goes through what circulates in the bloodstream, and everything that circulates in the bloodstream comes and goes through what enters the intestines. It is in the gut that everything about our health starts and ends, where all nutrients are absorbed and most metabolic wastes are discarded. This is why it must be the foundational focus of the healing process.

There is no better way to cleanse, detoxify and heal the gut than to drink fresh green vegetable juices while at the same time getting a series of colonics: the hydro-colon therapy cleans stuff out of the gut, the juice cleanses, alkalises and nourishes the blood and body. Doing these separately is very good. Doing them together is great. Give yourself two weeks—fourteen days—during which to do this. Every day drinking between two and three litres of fresh green vegetable juice, and every other day getting a colonic (on Monday, Wednesday and Friday, for example).

For the juice, you can make it or buy it, but it must be cold pressed in a slow masticating juicer, and it must be free of sugar, i.e., containing only green watery, fibrous and leafy vegetables. Any amount of sugar will fuel the proliferation of pathogenic bacteria and yeasts like candida, and one of the most important aspects of this gut cleansing and healing is the elimination of the candida which undermines the function and health of our gut and our entire organism. In many modern cities there are small cold pressed juiceries where it is possible to buy very good quality all-organic green juice. Doing it at home is less expensive but requires you to do the work. You can also make some yourself and buy some as well (that’s what I tend to do).

In addition to the juicing and hydro-colon therapy, there are three kinds of supplements that should be taken: probiotics (Prescript-Assist is what I take), L-Carnosine (Paradise Herbs is what I take), and enzymes (I’ve used pHi-Zymes by Baseline Nutritionals and Heal-n-soothe by LivingWell). The probiotics replenish and heal the flora, carnosine helps heal the lining of the gut and glycated tissues, and the enzymes promote accelerated repair of damaged cells. They should all be taken three times a day, morning, noon and late afternoon, always on an empty stomach. Take each time one capsule of probiotics and two of L-Carnosine.

To avoid being too hungry, but also to ensure an important intake of the miraculously healing coconut oil, you should have a coconut milk based smoothie, pudding or ice cream: a small glass, two or three times per day. And to make sure you have a good intake of salt and minerals, you should either put unrefined salt in the green juice or eat cucumber and celery sticks with salt, as much as you feel like depending on taste, once mid-morning and once mid-to-late afternoon. Sometimes you may want to drink salty green juice, and sometimes you may prefer to eat salty, crunchy veggies. Just follow your inclination.

(See the work of Dr Norman Walker for more details about the importance of colonics and juicing.)

Enzymes are proteins with specialised functions. They are the things that do stuff in the body. Most of us have heard that enzymes are made in the pancreas and are needed for digestion because they break down the nutrients into their constituents: starches are broken down into glucose by amylase, fats are broken down into glycerol and free fatty acids by lipase, and various proteins are broken down into amino acids by various proteases. These building blocks of foods can then be absorbed from the gut into the bloodstream and carried all over the body to where they are needed. But enzymes also do practically everything else that needs doing, and, in particular, heal and repair damaged cells and tissues.

All raw foods contain enzymes, some more than others. Fresh juices which contain a high concentration of minerals and nutrients, also contain a high concentration of enzymes. Because the more enzymes are available, the better it is for the body to heal and repair itself. Hence, our strategy for recovering from this stroke, heart attack we just had, is to flood the body with enzymes. The fact is that in western countries, most people live on processed junk food that is not only totally devoid of minerals and micronutrients, but also completely dead and devoid of enzymes. If we don’t survive on processed junk food, then we typically hardly ever eat anything raw. Therefore, even if the food we eat is not as bad as processed fast food, it is still cooked, dead and devoid of enzymes.

Eating this way leads to two major problems. The first is that the pancreas is continuously manufacturing enzymes in a desperate attempt to cope with the digestion of cooked and dead food, and over time, like within a few decades, begins to get exhausted and eventually becomes unable to produce any enzymes. It typically also stops being able to produce insulin at the same time, just because it is simply exhausted. The second is that because all enzymes are used for digesting processed and cooked dead foods, there are hardly any enzymes available for anything else that needs doing, healing and repairing.

In our healing programme, to flood the body with enzymes, we—in addition to drinking all this juice loaded with enzymes of all sorts—will supplement with more enzymes. There is no upper limit to the amount we can take, and the more the better. It is really just a matter of what we can afford and are willing to take on a short, medium and long term basis. It is important to start slowly and increase gradually. This is to allow the body to adjust to the presence of more enzymes, but also because they will immediately start their cleanup of the body, breaking down scared and dead tissues that inevitably accumulate over time, as well as both benign and cancerous tumours. The breakdown products are toxic and need to be eliminated quickly. Hence part of the importance of the initial 14 day juice cleanse with intensive hydro-colon therapy.

The amazing thing about enzymes is that they know exactly what to do, what to break down, what to build up, what needs help repairing and what needs help healing. This can be considered a miracle of nature. But it is just life: the self-organised life of living organisms that has been evolving and having its means and methods refining themselves over the 4.5 billion years of evolution on the planet. Self-organised, synergistic and symbiotic co-dependent emergence and evolution. Miraculous and amazing, but from the perspective of an enzyme, a chloroplast or mitochondria, it is utterly simple, obvious and straight forward: adaptation for improved survival.

(See the work of Drs Cichoke and Gonzalez for more on enzyme therapy.)

Iodine is an element that is needed in every cell. According to statistics from the WHO, 97% of the world’s population is iodine deficient. And according to David Brownstein, M.D., a physician who has spent a good portion of his medical career studying iodine, testing for it, and treating his patients’s deficiencies of salt and iodine, the figure is probably closer to 98 or even 99%. In any case, this means that we can conclude that everyone should be supplementing with iodine to ensure the body an appropriate supply.

Iodine is found in the highest concentration in the thyroid gland, mammary glands, and then other glands of the body. For all glands, but especially for the thyroid and breasts, it is simply crucial. Brownstein has treated with total success a large number of women suffering from fibrous cysts or cancerous tumours in the breasts, and a large number of both men and women suffering from thyroid-related dysfunctions using basically only iodine supplementation and dietary modifications (including, most importantly, increased unrefined sea salt intake). He states his belief that most if not all cystic breast disease and cancers, and that most if not all thyroid problems, regardless of whether they are hypo or hyper thyroid dysfunctions, are caused by iodine deficiency, and are always corrected with appropriate supplementation.

One of the reasons why iodine deficiency is so problematic is that because it is so important in its role in every cell, and because it is part of the halogen family of elements (F, Cl, Br, I, At), it is replaced in the cells by other much more abundant but toxic halogens like fluorine, chlorine and bromine. All of these being common industrial chemicals far too abundant in our environment, water and food, and that find their way into the body, slipping into those slots in the cells intended for iodine. It is only by supplementing and providing the body with the adequate amounts it needs, that these other halogens can be gradually replaced by iodine and excreted from the body.

Brownstein recommends using Lugol’s solution, which is sodium iodine and iodide dissolved in water. It is generic and inexpensive, as it has been around for almost 200 years (first made in 1829), and it is a safe and effective way to replenish iodine stores. For most people (as it was for Brownstein himself and for me) it will be necessary to take 50–100 mg per day for about a year. It should be taken in water or juice on an empty stomach. I took it with water for many months before starting to put it in the green juice, in which the taste cannot be detected. I use a 15% solution (18.75 mg per drop) and took between two and four drops per day (37.5–75 mg; two drops at a time, once or twice per day).

After almost a year, I felt two days in a row an immediate surge of energy and light butterflies in the stomach, which I knew were caused by the iodine stimulating the thyroid because I had read about it. Therefore, reacting to it with such sensitivity, I knew that I had finally replenished, after all these months, the iodine stores. Now, I take one drop in my green juice, which sounds like an infinitesimally small amount, but it is important to maintain supplementation because iodine is needed every day by all cells and it is water soluble making it easily excreted with the urine. It has been estimated by iodine researchers that the body needs a minimum of 12.5 mg per day. Therefore it is best to take a little more than that; one drop of 15% solution which provides 18.75 mg. Iodine is of fundamental importance. Supplementation with it is essential, especially in a detoxification and healing programme.

(See Brownstein’s book for more on iodine, and The Guide to Supplementing with Iodine, for additional details about supplementation)

Magnesium and sodium bicarbonate support the cleansing, detoxification and—very importantly—alkalisation of the gut, blood, tissues and organs of the body. The easiest and most effective way to get these into the tissues is to have a 60 minute bath with one cup of nigari flakes and one cup of baking soda. You should do this every other day (Sunday, Tuesday and Thursday, for example) for the first two weeks. This will help pull out accumulated acid, chemical toxins and heavy metals. It is very pleasant and relaxing to lie in a hot bath for an hour reading a book, listening to music or just lying there quietly, adding hot water to maintain a comfortably hot temperature. It is also an essential part of the detoxification programme. After the first two weeks, you can reduce the number of baths to one to two per week.

(See the work of Drs Dean and Sircus for more on magnesium chloride and sodium bicarbonate.)

Eating for rejuvenation and optimal health is a matter of choosing between health and life or sickness and death. After these first two weeks, you will start to eat more solid foods, keeping the juice as the pillar of your new way of nourishing and taking care of the body. In fact, every day the focus of the first half of the day will be to hydrate, cleanse and alkalise by drinking green juice, one litre in two 500 ml portions, at around 9–10 and then 11:30–12:30. Lunch around 14 will be a green smoothie made of avocado and/or coconut milk, together with other green leafy veggies (kale, celery, cucumber, spinach, etc), and coconut water for the liquid part. You can add salt, black pepper and/or cayenne, other spices, superfood powders or extracts, making the smoothie as nutritious and tasty as you can using your resourcefulness to come up with new ideas and recipes.

Having a smoothie of this kind provide lots of enzymes and nutrients, essential oils and excellent fats, together with the naturally occurring fibres but because they are chopped up and blended smooth, they are very easy to digest and thus cause very little digestive stress; this is second to juicing which removes all the fibres for maximum absorption of nutrients and minimum work by the digestive organs.

In the late afternoon, have another green juice if it’s possible. You should drink one to two litres of alkaline water per day, whenever you feel like it. (You can either buy it, making sure the pH is above 8, or you can add alkalising drops to your high quality filtered water. I use Young pHorever’s PuripHy.) Remember that water and juice intake must be balanced with salt in order to hydrate well and not dilute the blood sodium levels and causing the kidneys to excrete more water. We want to drink lots and eat lots of salt in order to super-hydrate. For each litre of water/juice you need about half a teaspoon of salt.

Stop drinking around 18 or so, approximately 45 minutes before dinner: a big leafy green salad of your choice (baby greens, baby spinach, romaine, oak leaf, kale, mixed lettuces and greens) with some nuts and seeds, plenty of cold pressed organic olive oil or some kind of nut or seed butter dressing, and with this big salad, have a small amount of grass fed meat or wild/organically raised fish every other night (one day on, one day off).

That’s it. This is how you should eat for all the months during which you are recovering until you are in perfect health and perfect shape. You can eat like this for the rest of your life. This is more or less what I do. Some variations, will include creamed vegetable soups with coconut milk in the winter (cauliflower, brocoli, celery, spinach), cold soups like gazpacho in the summer, different kinds of salads (celery-fennel, red cabbage, white cabbage, chopped up cucumbers, tomatoes and red peppers in the summer, soaked nut and seed parsley salad, etc), and different lightly steamed vegetables like brocoli, romanesco, cauliflower and green beans. Of course, you are welcome to experiment in this way depending on the season and on personal taste, mood and circumstances.

Supplements that you should take as soon as you start eating, some with lunch and some with dinner, are the following.

With lunch:
(2) Liposomal Magnesium (L-Threonate; Mercola)
(2) Liposomal Vitamin C (Mercola)
(2) Krill oil (Mercola)
(1) Astaxanthin (Nutrex Bioastin 12 mg)
(2) Turmeric extract (Gaia Herbs)
(1) Cinnamon extract (Stop Aging Now)
(1) Tulsi extract (Source Naturals)
(1) Vitamin B12 (Thorne Research Bio-B12)
(2) A-D-K (DaVinci)
(2) Niacinamide (Thorne Research)
(2) Synergy7 (Stop Aging Now)
(2) Zinc (Source Naturals OptiZinc)
(1) Ubiquinol (Mercola)
(1) Huperzine A (Source Naturals)

With dinner:
(2) Liposomal Magnesium (L-Threonate; Mercola)
(2) Liposomal Vitamin C (Mercola)
(2) Turmeric extract (Gaia Herbs)
(1) Cinnamon extract (Stop Aging Now)
(1) Vitamin B12 (Thorne Research Bio-B12)
(1) A-D-K (DaVinci)
(2) Niacinamide (Thorne Research)
(2) Zinc (Source Naturals OptiZinc)
(1) Ubiquinol (Mercola)
(1) Iron bisglycinate (Thorne Research; depending on blood test results)

You will have noticed the obvious absence of some classes of food products that are eaten by most people most of the time: there are no sugars of any kind and no starches, both of which are known to increase the probability of cardiovascular events by their instantaneous triggering of more than 300 inflammatory pathways, all of which cause the blood to thicken and become more viscous; there are also no dairy products, which are highly acidifying and usually the cause of negative immune responses from mild to severe intolerance or allergies; and there are no commercial foods or drinks, all of which should simply be avoided by everyone for their lack of nutrition and chemical toxic loads. These are detrimental to our health in several ways and therefore have no place in a healing programme or in a diet for optimal health and longevity.

You will also have noticed that there is a strong emphasis on green juices and green vegetables, coconut fat from coconut milk, and just enough healthy and clean animal protein and fats to provide the body with everything it needs to thrive. It is perfectly fine to have berries either on their own or with coconut milk, as well as 80-85% organic chocolate once in a while (and not later in the day than about 15). You can have organic green tea in the morning (until about 12), but stop drinking coffee (if you’re a big coffee drinker, you have to do this gradually). The adrenal glands—the very important stress and sex hormone producing glands—in this day and age are almost always overstimulated from our busy and stressful lifestyles, and therefore usually dysfunctional to a greater or lesser extent. They also need to be healed and for this, they need a break.

You should continue the probiotics, L-carnosine, and enzymes as long as necessary to regain total health. You can continue indefinitely. You should continue the iodine supplementation with 50–100 mg per day for a year (might be anywhere between 8 to 12 months), after which you should reduce to one drop of 18.75 mg, and maintain this indefinitely. You should continue all supplements for as long as the healing process continues, and will benefit from taking them to the end of your days, reducing the quantity to once per day instead of twice (dropping the evening supplements with dinner), and remembering that there are only benefits from taking more depending on the circumstances in your life and your body’s needs. Of course there are plenty of other supplements that we can be of benefit, but the ones listed are those that I consider most important.

If you enjoyed reading this article, please click “Like” and share it on your social networks. This is the only way I can know you appreciated it.

One of Hitler’s most devastating gifts to humankind

The Third Reich, under its Fuhrer’s rule from 1933 to 1945, but especially during the second world war, was in more ways than those most obvious to us, masterfully devastating in the scope and effects that would have its scientific research programmes.

One of the branches in which laboured a great deal of keen scientific minds was that of biological warfare with the use of poisonous chemical agents. What could be the most effective means to impede, disable, neutralise or completely remove someone’s abilities to fight or even resist? It would be to sever the connection between the central nervous system and a vital organ: pretty simple and definitely very effective.

German determination, dedication, focus, methodology and efficiency is well recognised and highly appreciated all over the world. This is true today as it was then, and if in this day and age it means to us more in terms of German technology—great industrial machinery and equipment, great cars, great appliances, great electronics—together with the fact that, on the world’s stage, we can trust their government’s word and commitment to seeing things through unwaveringly to the end, it certainly would have had a different connotation to the millions who suffered under the Germans during the great war, be it directly or indirectly. Regardless of these considerations, however, these qualities of determination, dedication, focus and efficiency are excellent qualities, well established in German culture and society, and obviously foundational in making the country a powerful and stable industrial and political leader.

It was to be expected that those scientists tasked to identify, develop and refine the biological and chemical technologies necessary to accomplish their intended function of quickly, silently and as effectively as possible disable the human target without as much as a single drop of blood being shed in the process, was indeed accomplished, and masterfully so. The result was chemical agents that were called ‘nerve gas’.

Nerve gas worked exactly as it was intended: it broke the biochemical connection between the brain and the heart. More specifically, it inhibited the enzyme cholinesterase whose critical function is to break down excesses of the neurotransmitter acetylcholine that enacts the brain’s messaging to the heart in order to avoid overstimulation. Acetylcholine is there to trigger the firing of neurons that control heart and bowel function. It sits in the synapses, the gap between neurons, and does this. The mechanism to ensure that there is enough but not excessive acetylcholine nerve stimulation, is the enzyme-depended breakdown of any surplus acetylcholine. Without optimal function of the enzyme cholinesterase, acetylcholine accumulates between neutrons and induces overstimulation, which can quite effectively bring the heart to a stop without bloodshed, without pain, without any noise, and without any drama: just quickly and effectively.

How does nerve gas work today? Precisely in the same way it did in 1945. It was recognised early on in this research that most, and maybe all animals, no matter how large or small, share if not identical, very similar biochemical and hormonal pathways, especially in terms of nervous system function. Can you see where this is leading?

The technological developments during the era of the second world war were tremendous: the planes, the cars and trucks, the tanks,  the guns, the bombs, and all the physics and engineering, the chemistry and the biochemistry involved. It really was revolutionary in regards to the power available at our fingertips to do whatever we could imagine or whatever was needed to make things simpler, easier, more efficient. What came of all this was global, widespread use of large , complex machinery and global, widespread use of chemical for anything and everything we could think of.

The shift from traditional family farming, which since it began 10000 years ago was always done on really very small scales, and naturally with the largest workable and sustainable variety of plant species being grown together, to the modern ways that could best accommodate the limitations imposed by using great big machines instead of our hands to tend the fields, gave way to huge monocultures, which in turn, gave way to huge problems with insects attracted to these particular species of plants being grown without the natural balancing effects of competing or antagonistic insects attracted to different plants growing side by side in the small space of the family garden.

Just follow this impeccable human logic: nerve gas kills humans by blocking the action of the enzyme cholinesterase required to regulate the amount of stimulation triggered by the neurotransmitter acetylcholine that controls heart function by adjusting neuron firing and breakdown rate; all higher animals, including insects, have similar functioning nervous systems because we all evolved from the same primitive ancestors whose most essential function were controlled by their nervous system, whatever form it took; we want to cultivate huge fields of monocultures because it is efficient in producing large quantities of food without much time or labour by using large machines to take care of these field; unfortunately, large monocultures attract disproportionally large numbers of the same kinds of pests that then have free reigns over the plants cultivated because they have no other insects to compete against; insects are affected in similar ways as we are by nerve gas, but because they are much smaller, because we are so much larger and stronger than they are, they would be lethally affected by small quantities of nerve gas while we would not, or at least not very much.

It’s perfect! Amazing! We spray diluted nerve gas on our large mono-cultured crops, kill all these awfully annoying insects that are trying to eat our food, and then simply collect everything intact and in perfect condition. This is the magic of industrial chemistry. What do we call this diluted nerve gas, these chemical agents? Pesticides, of course. Very popular right from the start, but incredibly more popular today than 70 years ago.

In fact, pesticides are more than 30 times more popular today than they were in 1945. Every year we dump more than four billion pounds of pesticides on the soil of the Earth. Four billion pounds worldwide, and one quarter of this—one billion pounds—is used in the US alone!

As can be expected from our amazing human ingenuity, cleverness, tenacity and industriousness, there are now tens of thousands of different kind of ‘nerve gases’ with different purposes, different functions, different effects and different potencies. We are so darn good, so clever at improving things, making them longer lasting, more effective, more targeted, more concentrated, and naturally… more lethal.

The obviousness of the truth is painful and so we look away: all pesticides are neurotoxic because this is how they function to kill pests. But since we are also a pest of sorts, they are neurotoxic to us in the same way as they are to those insects we want to get rid of. As a result, we are killing the insects, and we are killing ourselves. Moreover, we are doing it better and better each year and with every passing day. That’s the long and short of it. Sorry to be the bearer of such bad news.

Yes, we can eat our own home-grown stuff, and exclusively organic and pasture raised food—I do and have been for the last 18 years since graduating from McGill in the spring of 1996. But pesticides are in the rivers, oceans and water tables, as well as in the air, the clouds and the rain. And this, in ever-increasing concentrations. What we can do is try to protect ourselves as best we can by minimising our ingestion of and exposure to such poisons by all the means available to us, integrate continuous detoxification practices in our daily life, and do whatever we can to shift the balance of policymaking towards the support of small scale organic farming and away from the industrial monoculture model pervading over so much of the planet. Maybe the trends will change, and maybe sooner rather than later, but it’s hard to tell.

With the opportunity and truly great privilege we have to be alive and able to look back onto the past, and consider anew the circumstances, events and developments that took or might have taken place with a fresh perspective encompassing a multitude of informative elements available to us now but that were not at the time, I believe that nobody could have foreseen that the chemical technology of biological warfare agents developed during the second world war in Germany would become so incredibly popular as to pervade the entire planet to the extent of reaching virtually all ecosystems from the poles to the equator, up and down and all around to the most isolated and distant. And although seldom recognised as such, it is this, one could argue, that has had the most important and pervasive negative impact on humankind, one of the most devastating consequences of Hitler’s lethally poisonous legacy: the gift of pesticides.

If you enjoyed reading this article, please click “Like” and share it on your social networks. This is the only way I can know you appreciated it.

Is it really a fault in our stars?

All these stars, these countless stars we see in the sky at night, are the souls of little children waiting to be born. When a mom and a dad love each other and get married, a star comes down and an angel brings one of these little souls into the belly of the mom. Then, it grows into a baby and, after 9 months developing inside the mother, comes out and becomes a sweet little child like you.

childrenLookingAtNightSky

This is what my mother explained to me when I asked her where children came from. I don’t know if this is a popular story, one that many parents tell their children when they ask them where they came from, but it is a sweet little story that happens to be far easier for a young child to understand than how things really happen. It also transmits a sense that each child, the life of each child, is magical and mysterious in origin, and therefore incredibly special. This is true: Life is magical, its workings are mysterious, and it is on the whole truly amazing.

A few nights ago, on new year’s eve, out son went to sleep over at a friend’s house, to watch a film (2001 Space Odyssey) and ring in the new year. My wife and I stayed home and watched a movie together. We watched The Fault in Our Stars, Josh Boone’s film of John Green’s book that our son first read and then watched, and highly recommended.

It is a touching story about two young people, Hazel-Grace and Augustus, that fall in love, with one another, deeply and sincerely in love. But their friendship lasted a very short while only because of Augustus’s quick, and in some ways, unexpected passing away. Hazel and Gus met at a meeting of a cancer support group where he went to accompany his best buddy who had recently learned they were going to take out his second eye due to the spread of his childhood retinoblastoma, and where she went to please her mother who insisted she go to meet people with whom she would have at least one thing in common: her life-altering and debilitating childhood cancer.

Hazel developed lung cancer when she was around 13, and lost one of the two lungs some time after that, and was, since then, living with a small oxygen tank she had with her at all times throughout the day and night, a little tube bringing oxygen into her nostrils, providing her with the oxygen she needed to survive. Augustus right leg had been amputated due to an aggressive cancer a few years back, but looked to be in very good spirits, an inspired and inspiring young man. I won’t say anymore about the film because you really should watch it for yourself. It is very good.

The picture that is painted of the world seen through the eyes of these young people is indeed very different from what most of us who do not suffer from serious illnesses are accustomed to. They know very well and unambiguously not only that their days are counted, but also that the end can come at any time, even without a moment’s notice, today or tomorrow, next week, next month or next year, but surely and without a doubt about it. They know and have in the forefront of their consciousness the unavoidable fact they they are dying, that they are at the mercy of death.

The truth is that this is also true for everyone everywhere. It’s just that the perception of it and the timescale are different, or at least it tends to be: before being afflicted or diagnosed with a typically deadly disease like cancer, we tend to act and think that we will live forever, or at least for so long that it’s really not relevant to consider how long because we’ll be old and frail and our children will have families of their own, and our grandchildren will themselves already be grown ups, and on and on; after becoming seriously ill or receiving a crippling diagnosis, we immediately see the end, we see our end, as something actually really close to us, and, unfortunately unavoidable.

Even if the film is very sad, it is also very inspiring, giving us, all of us who are still alive, so much to be thankful and grateful for. This is what I felt. And this is what I said to my wife as we were lying in bed before falling asleep, after the distant fireworks and local firecrackers had finally subsided: we are just so lucky, so incredibly lucky.

For children like Hazel-Grace and Augustus, children who develop cancerous tumours in the womb already, in the first few years of life, or a little later, is something totally incomprehensible: how can such a thing happen at such a young age, or before even being born! What have they done to deserve this? This is not intelligible, not acceptable, simply not possible. Naturally, it can only be a ‘fault in our stars’, a fault in their stars. It cannot be anything else. It must be some kind of problem at the source, at the mystical, magical source of the life of these poor, unfortunate, afflicted children.

This may be a way to help us accept the situation and just make the best of it for as long as possible, with strength, compassion and courage, but it is a lie. A romantic and poetic lie, but a lie nonetheless. The truth is that cancer is never, has never been, and never will be a ‘fault in our stars’, a stroke of bad luck, an unfortunate turn of events. Whether it develops while we are still in our mother’s womb, when we are three, five, ten, thirteen, eighteen, thirty three, forty two or sixty nine, it is never due to chance.

For cancer to develop two conditions must be fulfilled: there needs to occur an initial structural damage at the cellular level, and there needs to be a biochemical/immune environment that permits the subsequent development and evolution of the cancer cells. Without these, cancer cannot develop. Under optimal biochemical and immunological conditions and function, cancer cells that do appear for whatever reason are immediately destroyed, cleaned out and replaced by healthy cells.

For unborn children, there is little doubt to be had that cancer can primarily be due to the mother’s having been exposed either prior to or during pregnancy to carcinogenic agents: respiratory poisons, hormone disruptors or mutagenic substances. The embryo is so fragile and so vulnerable, especially to respiratory poisons because of its propensity towards glucose fermentation, that minute amounts otherwise unnoticeable by the mother can be enough to cause the formation and growth of what will turn out to be large tumours by the time the baby is born, often the case for retinoblastoma as in the case of Augustus’ closest friend, and, as it happens, in the case of the daughter of a close friend of mine, the baby is usually born with at least one of the eyes’ optic nerve covered in cancerous tumours, prompting the removal of the eye and nerve as soon as this is identified.

Throughout childhood, the less mature child is always more vulnerable and fragile than the more mature individual, and this is always thus in relation to the maturity of the cells, tissues and organs of the developing child. Some cells and tissues are more vulnerable, like the brain, for example. But all immature cells are significantly more vulnerable than their mature counterparts. And knowing that all immature cells tend to higher fermentation rates, shouldn’t it be considered the most reasonable approach to completely restrict sugars and carbohydrates at least until the child has reached the first stage in maturity at about 7 years of age, feeding them mostly fat in natural forms and chlorophyl-rich vegetables, keeping glucose and insulin as low as possible and thus ensuring that any damaged (pre-cancerous) cell relying on glucose fermentation will silently perish and be swept out before even the smallest cluster of such cancer-promoting cells has formed, let alone a full blown tumour, the smallest of which contain billions of cancer cells?

Shouldn’t it be considered only reasonable to just stop behaving so ridiculously irresponsibly towards ourselves, towards our children, towards our environment: the air, the soils, the lakes and rivers, the seas and oceans? To stop dumping so much chemical rubbish in our bodies, in those of our children and in the world all around us? It seems to obvious yet for some reason it isn’t to most people, and certainly not to politicians and policy makers worldwide who seem to be precisely those least apt to make those decisions and formulate those policies intended to minimise damage and disease by restricting the production and release of poisons in air, water, soil and food.

At least, at the very least, we have to stop feeding ourselves and our children foodstuffs that are devoid of nutrients and laden with sugar, chemicals and other man-made, denatured molecules like trans-fats and high fructose corn syrup. At the very least, we have to start simply drinking plain, pure and clean water: not juice, not milk, not soda or other sugary drinks, just water. We have to start eating fresh whole foods, those that don’t have labels, that are not wrapped in plastic, and that do not come in box. And we have to just stop using chemicals in our showers, kitchens, in our homes and in our gardens.

It’s so simple, but I so often feel stupid saying and writing things of this sort just because is it so simple and obvious. And yet, it’s amazing how rarely I encounter people who also see these principles as obvious. If you don’t yet, please think about it for a while, and ask yourself this: what are, if not these, the most basic steps to take to ensure our own health and that of our children, those growing up around us and in our care, those curled up in the warm and cosy space of their mother’s womb, and those yet unborn and not yet conceived either in thought or in actuality, those little stars shining silently in the night sky?

If you think this article could be useful to others, please ‘Like’ and ‘Share’ it.

On the origin of cancer cells – part 2

Fifty years of intense research had passed from the year he received his doctorate in chemistry in 1906 to the year when On the Origin of Cancer Cells was published in 1956. The uniquely exceptional scientist that was Professor Otto Warburg was nominated for the Nobel Prize by his scientific peers a total of 46 times between 1923 and 1931, with 13 of these nominations in that last year. And in 1931, he was awarded the Nobel Prize for his seminal work on the essential role of iron in the biochemistry of cellular respiration published in 1928, and more generally for his work on the aerobic and anaerobic metabolic processes in cells. He was also, in that year, made director of the Kaiser Wilhelm Institute for Cell Physiology in Berlin (renamed Max Planck Society in 1948), and he maintained not only his post but also his scientific activity until his death in 1970 at the age of 86.

otto-warburg-old-highresfaceshot

In fact, in 1969, just months before his passing, he published with one of his long-standing collaborators Dean Burk who translated the text (as he did for the 1956 paper), a revised and additionally prefaced version of the lecture he gave at the meeting of Novel Laureates at Lake Constance, Germany, in 1966 entitled The Prime Cause and Prevention of Cancer. The tone of this lecture, both for the first part of 1966 and the second of 1969, transpires frustration and even anger at the general lack of notice and acceptance of the crucial elements of the physiology of cancer cells that he had studied, understood, elucidated and clearly described in his publications over the course of more than 60 years of research.

Attempting to formulate a well-rounded and balanced explanation would require a lot of time and effort, not to mention a lot more words. But it is evident that then as now, financial interests have generally always been among the strongest driving forces both in research and in developing applications based on the understanding derived from this research. Hence, it is more than clear that eliminating the use of chemicals in all agricultural and industrial processes, stopping the consumption of simple and starchy carbohydrates and refined foods, and supplementing with iron, niacinamide and enzymes in general like Warburg recommended and did as a means to prevent and treat cancer is not only not at all lucrative, but it is highly financially detrimental to all chemical-based agricultural and industrial activities. I believe this is a most important part of the explanation, as it is for so many things.

What Warburg understood

Warburg had slowly, carefully, cautiously, diligently, painstakingly carried out experiment after experiment, trial after trial, studying every last detail of every aspect of the experimental process. He explained the cell’s most vital function, that of respiration, using oxygen to burn glucose or fats and produce energy, with a particular focus on the critical role of iron as a ‘respiratory enzyme’ carrying the oxygen molecule. He explained that the glucose molecule was ‘fermented’ (that it underwent glycolysis) in the cytosol of the cell, split into pyruvate molecules and fermented to lactic acid, and that this produced a small amount of adenosine triphosphate (ATP) without the need or use of oxygen. This process is termed anaerobic fermentation.

He explained that this process could either stop there, or be extended further by the pyruvate being taken up into mitochondria of the cell, and with the use of much oxygen, almost magically produce a lot more ATP without needing any additional glucose, but going through a series of steps and transformations relying primarily on clever recycling and reusing mechanisms of the niacin (B3) based molecule NAD (which stands for Nicotinamide Adenine Dinucleotide) within the mitochondria.

The ATP-generating process taking place inside the mitochondria was eventually described in detail by one of Warburg’s students, Krebs, who was awarded a Nobel Prize in 1953, and to which his name was given as the Krebs cycle also known as the citric acid cycle, as everyone who has studied some biology has heard (even if you never quite understood was this stuff was all about). Note that the Krebs cycle produces only 2 molecules of ATP, just as glycolysis does, and that it is what is called the electron transport chain, also taking place inside the mitochondria and using plenty of oxygen, that produces the bulk of the ATP with a potential of an additional 34 molecules, using products of the Krebs cycle, and in particular the 10 molecules of NADH.

Warburg was motivated to understand at the most fundamental level what was the difference between healthy cells and cancer cells. Naturally, as cancer was already a devastating disease in the 1930’s, he wasn’t the only scientist working and leading researchers in the study of the mysteries of cancer. He was, however, one of the most talented, dedicated and productive, together with the group of scientists he led at the Kaiser Wilhelm Institute and those with whom he collaborated.

The first major step was made in showing that tumours fermented glucose much more intensely than healthy tissues that normally hardly do so at all. This fact—that tumours ferment a lot more glucose than healthy mature tissues even in the presence of oxygen—is known as the Warburg Effect and is universally studied in physiology, medicine and oncology (cancer-ology). This fact is so fundamental to cancer metabolism as well as cancer research that it is the basis of the PET scan imaging technique in which radioactively labelled glucose is used to make detailed images of active tumours and their tendrils in our tissues. The reason why it works is that cancer cells take up glucose from the bloodstream far more efficiently than normal cells.

What is unfortunate but not surprising given how myopic scientists and we all in general tend to be, is that this has been consistently overlooked as being a critical aspect of the genesis of cancer, as Warburg’s research implied, and instead has been interpreted as a consequence of the dysfunctional cellular metabolism of these mutated cells that is unrelated to the actual development of the cancer.

This is pretty absurd. After all, if cancer cells derive a substantial fraction of their energy from fermenting sugar, wouldn’t the absence of sufficient glucose naturally halt the growth and proliferation, and thus the development of tumours? And even more fundamentally, because glucose can only be transported inside the cell by the action of insulin, and it is, in fact, to insulin—not glucose per se—that cancer cells are incredibly more sensitive than healthy cells, wouldn’t an important drop in circulating insulin levels be detrimental or even lethal to cancer cells? Of course it would! They would be starved of the only fuel they can use, and as a consequence, eventually become incapable of sustaining their activity.

How was this measured?

The way it was done was to measure oxygen consumption and lactic acid production either with plenty of oxygen or without any, for tumours and different tissues under physiological conditions of pH and temperature. This is the perfect trick because fermentation outside the mitochondria does not require any oxygen, whereas energy production by glucose oxidation inside the mitochondria depends entirely on the presence of ample amounts of oxygen, In fact, even a minute drop in oxygen concentration will negatively affect mitochondrial ATP production. Cancer cells don’t care much if there is oxygen or not: they don’t use much and therefore don’t depend on it. They ferment glucose anaerobically no matter what because this is the only way they can generate enough energy to survive.

It was understood a number of years later that tumours are rather heterogenous both in terms of the types of cells and tissues they are derived from, and in the concentration of cancer cells: tumours can grow extremely fast or extremely slowly; they can have a large proportion of cancer cells in relation to normal cells or a small one; and since different specialised tissues require different conditions and function differently, it is an obvious consequence that tumours developing in different tissues will have different characteristics.

Hence, the next step necessitated the isolation of cancer cells in order to avoid the problem of dealing with heterogeneous mixtures of cancer and healthy cells cohabiting in a solid tumour. It was this that Warburg presented in the 1956 paper, and what a difference this would make! These are his opening paragraphs:

Our principal experimental object for the measurement of the metabolism of cancer cells is today no longer the tumour but the ascites cancer cells living free in the abdominal cavity, which are almost pure cultures of cancer cells with which one can work quantitatively as in chemical analysis. Formerly, it could be said of tumours, with their varying cancer cell content, that they ferret more strongly the more cancer cells they contain, but today we can determine the absolute fermentation values of the cancer cells and find such high values that we come very close to the fermentation values of wildly proliferating Torula yeasts.

What was formerly only qualitative has now become quantitative. What was formerly only probable has now become certain. The ear in which the fermentation of cancer cells or its importance could be disputed is over, and no one today can doubt that we understand the origin of cancer cells if we know how their large fermentation originates, or, to express it more fully, if we know how the damaged respiration and the excessive fermentation of the cancer cells originate.

This was the programme that in the end led to the discovery that cancer cells produced 2-3 times (that’s 200-300%) more lactic acid than the most solid tumours. This meant that even those most solid tumours must have been composed of only about 1/3 active cancer cells, and thus 2/3 normal and inactive cancer cells.

This is necessary because cancer cells cannot do the things needed for the tumour to survive and grow, like making new blood vessels for example; only healthy cells can carry out such specialised activities. The wildly fermenting and proliferating cancer cells are dependent on healthy cells in the tissue where they are growing in order to survive. This makes good sense given that cancer cells gradually devolve, generation after generation, losing their function, their specialisation and their differentiated nature, and eventually cannot do much of anything but ferment glucose and replicate. For this reason, they rely on the healthy cells to maintain a viable environment for them.

Oxygen is crucial

Recall a key observation that was made in comparing the metabolic activity of cancer cells to normal cells: as the cell transitions from functioning normally and deriving virtually 100% of its energy needs by burning glucose (or fat) with oxygen inside the mitochondria, towards the defective cancerous cellular metabolism characterised by fermenting glucose without oxygen outside the mitochondria, they derive progressively more energy from fermentation and less from oxidation, independently of the amount of oxygen available.

You see, if oxygen in the cell drops, then ATP concentration drops because the mitochondria need the oxygen to make ATP. Immediately, fermentation outside the mitochondria will begin or increase in order to make up the energy deficit. This is normal and happens in all healthy cells whenever this situation occurs. However, the drop in available oxygen will also trigger heart rate and breathing to increase in order to make more available. This will very quickly correct the problem, allowing the cell to stop fermenting and return to the much preferred condition of generating ATP though oxidation in the little power plants that are the mitochondria. Once again, this is perfectly normal and happens in healthy, well-functioning cells every time we exercise.

Those cultured cells with which they were working did not have the support of the entire organism that we have, exquisitely fine tuned and orchestrated by countless specialised hormones, sensor cells, worker enzymes, etc., to react instantly to any kind of chance of condition. As oxygen concentration dropped, fermentation increased. But if oxygen levels weren’t replenished quickly enough, the damage to cellular respiration was found to be irreversible. Now, fermentation continued no matter if oxygen levels were raised to saturation following the period of hypoxia.

Not only did fermentation continue under oxygen saturation, but it increased over time. This is what was meant by irreversible in terms of the damage to respiration sustained by the period of deficient oxygen levels, and this is what showed very clearly how a cell can transition and devolve from normal and healthy to cancerous. The same observations were made irrespective of the means that were used to damage respiration: arsenic, urethane, hydrogen sulphide and its derivatives, hydrocyanic acid, methylcholanthrene and whatever else, whether oxygen was deficient or prevented from reaching the cell by a respiratory poison, the result was irreversible damage that always eventually resulted in cancer cells if the damage wasn’t too severe, because otherwise the cell would not survive at all.

The unavoidable consequence of this was immediately understood: it is the cumulative effect of chronic exposure to small amounts of carcinogenic respiratory poisons or low-oxygen that causes and leads to cancer within our tissues. Very unfortunately for us, the number, spread and quantity of such carcinogens grows with each passing day. Is it any wonder then, that cancer rates are soaring? That it is a modern plague in our highly industrialised, pesti-cised, herbi-cised, fungus-ised and globally chemi-cised countries?

Measuring cancer cell metabolism

Quantitative measures of cellular activity and metabolism of ascites cancer cells were done keeping the cells in their natural medium, ascites serum, that was ‘adjusted’ physiologically once they were removed from the abdominal cavity. Adjusted how? By adding glucose to feed them, but also bicarbonate to neutralise the lactic acid, because the fermentation rate was so strong that without the bicarbonate the pH would drop too quickly and too drastically, causing fermentation to be brought to a standstill and soon after the cells to die.

Under physiological conditions of pH and temperature, in units of cubic mm for 1 mg of tissue (dry weight) per hour at 38 C, they found the following:

  • Oxygen consumption: 5 to 10,
  • Lactic acid production with oxygen saturation: 25 to 35, and
  • Lactic acid production without oxygen: 50 to 70.

Warburg and colleagues estimated that in anaerobic glucose fermentation, one mole of ATP was produced for every one mole of lactic acid. In contrast, even though the exact details were not yet known, measurements indicated that in cellular respiration, 7 moles of ATP could be produced for every mole of oxygen that was consumed. Based on these estimates, they compared ATP production form fermentation and oxidation in different types of cells.

Healthy liver and kidney cells showed identical metabolic values, consuming 15 cubic mm of oxygen per mg per hour, and in the absence of it, producing only 1 cubic mm of lactic acid. This means these cells were very poor at fermenting glucose; they could basically only derive energy from oxidation within the mitochondria. And this was made even more apparent by comparing, as they did, the amount of ATP that can be derived from fermentation or from oxidation. Using the 1:1 ratio of lactic acid to ATP under fermentation, and the 1:7 ratio of oxygen to ATP under oxidation, they found that these healthy liver and kidney cells could derive 105 (that’s 15 x 7) moles of ATP from oxidation versus only 1 from fermentation. As a fraction of the total, this is 105/106 or 99.1% from the normal mechanism reliant on the Krebs cycle and electron transport chain inside the mitochondria.

Next they looked at very young embryonic cells and found equal oxygen consumption of 15 cubic mm, but with a significantly greater—25 times greater—production of lactic acid when oxygen supply was cut. What this means is that these embryonic cells were much better adapted to surviving in anaerobic conditions without oxygen. This is quite natural given that the less evolved the cell, the more primitive and less specialised or differentiated, and therefore the closer to simpler cellular forms like yeasts. Doing the same as above in translating this metabolic function to compare the amount of ATP derived from either anaerobic or aerobic usage of glucose, we find that the same amount of 105 cubic mm of ATP from respiration, but in this case 25 moles of ATP from fermentation. And so, in this case the fraction is 105/130 or 80.8%, compared to the above 99.1% in normal liver and kidney cells.

The difference between these numbers and those calculated for the ascites cancer cells was large: they consumed less than half the oxygen, 7 cubic mm, but produced a whopping 60 cubic mm of lactic acid. That was 60 times more than the healthy mature liver/kidney cells! Here, ATP derived from respiration was therefore 49 (7 x 7) compared to 60 from fermentation. Hence, the fraction of the total that could be derived from oxidation was a mere 49/109 or 45%, implying that more than half the energy requirements could be derived from fermentation. This is how these quantitative measurements on the metabolism of healthy and cancer cells were done, and the result was indeed a remarkable finding.

What these results explained

So many things were understood or clarified through his efforts across these five long decades of intense research, and now with these latest results we understood different cell types have different propensity to become cancerous based solely on the cell’s inherent propensity towards fermentation: the higher the amount of ATP that could be derived from anaerobic fermentation, the easier it would be for the cell to become cancerous, and also the faster the tumour would grow.

The unfortunate but unavoidable implication is that embryos whose cells are all immature and therefore more primitive and naturally prone to greater fermentation, are the most susceptible to sustain damage to respiration whether from periods of low oxygen (think asthmatic mothers) or from exposure to respiratory poisons (think anything from pesticides, herbicides, food preservatives, to just supermarket household ‘cleaning’ and skin ‘care’ products, synthetic perfumes or substances they contain, and on and on…). Here again we can ask: is it any wonder that infantile cancer rates are also on a sharp rise?

We understand, for exactly the same reasoning, why cancer tumours in different tissues grow at different rates under the same physiological conditions, and easily explain why the increase in fermentation is gradual, requiring many cell divisions after the initial injury. As we know very well, it typically takes decades for adults to develop large cancer tumours that cause enough of an effect to get us to the hospital before it is diagnosed as such. Also, we know that tumours in or near the brain can develop and grow very quickly—within a year or two—whereas for the prostate they typically take an entire lifetime, sometimes completely unbeknownst to the host whose quality of life is not affected noticeably.

It was also understood why radiation therapy was generally effective at reducing the size of solid tumours by killing those already weakened and energy deficient cancer cells through a final blow to their injured and struggling mitochondria. By the same token, however, radiation will also always damage mitochondria of healthy cells, and thus set them on their way towards the process of devolution into dysfunctional fermenting cancer cells that the injury to respiration brings about.

And imagine this: 52 years following the publication of this landmark paper and a whole three quarters of a century after Warburg’s discovery of the fermentation of tumour cells even in the presence of oxygen, was published in the journal Nature a paper entitled The M2 splice isoform of pyruvate kinase is important for cancer metabolism and tumour growth. In this paper the authors describe how they were able to manipulate the expression of this enzyme in cancer cells, and doing so, decrease fermentation while increasing oxidation of glucose.

This enzyme, pyruvate kinase, is expressed in mammals in four different flavours (isoforms): L is expressed in liver cells, R in red blood cells, M1 is by far the most dominant and is expressed in most adult tissues, and M2, a variant of M1, is expressed during embryonic development. As it turns out, and as reported by two other groups of researchers in 2005 (refs 2 and 7 in the 2008 Nature paper), tumour tissues exclusively express the embryonic M2 form of pyruvate kinase.

Expressing these results as simply as we can, the situation appears to be as follows: once a glucose molecule enters the cell through one of the insulin-mediated entry ports, it is in the cytosol. There, through a series of 10 enzyme-mediated steps, it is split in two molecules of pyruvate. This requires 2 ATP but produces 4 ATP molecules; hence there is a net production of 2 ATP. At this stage pyruvate can either be converted to lactate which then turns to lactic acid, or to acetyl-CoA which is then transported to the mitochondria to enter the Krebs cycle and the electron transport chain. This transformation of pyruvate is performed by the enzyme that is the subject of these scientists’ investigation, pyruvate kinase. It would seem that the M1 form, the one that is active in healthy cells, takes pyruvate into acetyl-CoA and into the mitochondria, whereas the M2 form, the one that is expressed in embryos and cancer cells, takes it into lactic acid.

By some clever genetic manipulation, working with tumours in rats, they were able to switch off M2 expression and switch on M1 expression in cancer cells, and measured a decrease in lactic acid production and an increase in oxygen consumption that was associated with ATP production in the mitochondria through oxidative phosphorylation. This is the remarkable result that made the paper worthy of a publication in Nature magazine. And it is indeed amazing! This is why they write in the first paragraph that based on their research, the defect is not with the mitochondria as Warburg thought, but rather it is with the expression of the enzyme pyruvate kinase that goes from the healthy M1 to the embryonic M2 form. Why or how this happens is unknown.

This is indeed very encouraging! Just the idea of being able to force the expression of the healthy M1 and suppress the cancerous M2 form of pyruvate kinase is really amazing and has very important potential implications for cancer prevention and treatment. And this even if we don’t really yet know why or how it happens. But tell me, have you ever heard of this more than critically important result in cancer research on the news? Do you think your doctor has? Or his oncologist colleagues that cut, poison and burn cancer patients day in and day out?

Our basic cancer-fighting strategy?

What can we gather from this work that can help us not just understand Warburg’s research and his remarkable contribution to humanity though it, but also avoid cancer in this world where more than 1/3 of people currently succumb to it and where cancer rates keep rising every year?

Naturally, we want to minimise as much as possible our exposure to all manufactured chemicals, especially those confirmed as carcinogenic. We are all exposed to a greater or lesser extent through our being immersed in the environment in which we live, but we can go a long way by eating the cleanest, most natural and unprocessed food possible, drinking the cleanest water possible, using only natural cleaning and skin care products, and using regular or daily detoxification strategies such as taking sodium bicarbonate and magnesium chloride baths one to three times a week, drinking psyllium husks in water to cleanse the colon, and supplementing with iodine, chlorella and spirulina daily to flush out chlorine, fluorine, bromine and heavy metals like lead, mercury and arsenic on a continuous basis. These are, in a way, the simplest and easiest preventative measures we can take to reduce as much as we can our exposure to external sources of potentially carcinogenic and otherwise dangerous substances, as well as do what we can to flush them out to prevent accumulation in our tissues.

In consideration of the two fundamental characteristics of cancer cells—that they rely on glucose fermentation, and that they live and thrive in a milieu that his highly acidic and deprived of oxygen—it is just common sense to conclude that doing the opposite of what they need and prefer would be a good strategy. Doing the opposite means minimising glucose availability and especially insulin that is ultimately the agent responsible for transporting the glucose into the cell; remember that this is why cancer cells typically have 10 times the number of insulin receptors on their surface than normal cells. Doing the opposite also means preventing the accumulation of metabolic acids in their subsequent storage in tissues, preventing latent tissue acidosis, and ensuring a plentiful oxygen supply from a highly alkalising drinks, foods and lifestyle.

The first can be achieved by eliminating all simple and starchy carbohydrates, refined or not. Blood glucose levels will drop, and insulin levels will follow suit. This will shift the metabolism towards relying on fat as the primary source of cellular fuel throughout the day and night, day after day. The cool thing is that healthy cells function much more efficiently by burning fatty acids in the sense that they derive a lot more energy than they can do from burning glucose, even if the later is easier and enzymatically simpler: it is, after all, common to all living organisms, including the most primitive. The important difference is that all evolved and highly specialised animal cells can use fat, whereas primitive or devolved cancer cells simply cannot.

The second can be achieved by keeping the body hydrated and alkaline by drinking and eating to promote the alkalisation of the digestive tract, the blood, the other fluids of the body, and thus the tissues throughout: alkaline water and pressed lemon water, highly alkaline and alkalising freshly cold pressed green vegetables both juiced and whole, and magnesium chloride and sodium bicarbonate baths. Eating plenty of unrefined sea salt is also of the utmost importance in this. These are among the most important and effective means to first pull out and eliminate stored acids from the tissues and body, and then maintain alkalinity.

The only caveat is that digestion of concentrated protein in animal food, for example, require an acidic stomach for complete breakdown and digestion. Therefore,we should not combine alkalising water, lemon water or green juice when eating protein because this will cause poor digestion and absorption. Also, because protein is very important but also highly acid-forming, it is essential to not have excessive amounts, especially in a single serving, because this will cause excessive acidification and toxicity. Restrict your servings of animal protein to about 30-50 grams per serving, and try to restrict that to one main meal in the latter part of the day (afternoon or evening).

Pretty simple, aren’t they, these two strategies that we can draw from what we have learnt about cancer up to now. We will further explore cancer metabolism, prevention and treatment in the future, looking at methods that have been and continue to be successfully used to treat cancer patients and bring them back to health, as well as important nutrients and supplements with powerful cancer-fighting and health-promoting properties. But the fact is that these two basic points that address the most fundamental characteristics of cancer cells to ensure, on the one hand, that those that do emerge one way or another cannot sustain themselves or grow due to the lack of enough glucose and insulin for their needs, and on the other, cannot readily develop from being pushed towards fermentation because the environment of the body is everywhere alkaline and oxygen rich, are probably the most effective and important measures to grasp and apply in order to remain optimally healthy and cancer-free for as long as we are alive.

In closing

Before closing I want to briefly highlight that the vast majority of effective natural cancer healing treatments are based to a greater or lesser extent on the understanding of cancer as I have presented it in this and the previous article on the subject. However, there is a truly wide range of successful treatments that are used out there in various specialised cancer treatment centres. One important point to make in regards to the consumption of simple sugars from sweet root vegetables such as carrots and beets or fruit is that several treatment protocols include these and in sometimes large quantities still with great success in overcoming cancers of various kinds. This shows us that there is definitely more to preventing and treating cancer than just eliminating simple sugars.

There is lot of tremendously interesting material to explore about cancer, a disease that has been an important cause of suffering for at least a century. A lot of this exploration will be of historical research, experiments and discoveries that either have escaped the attention of the masses and medical establishment, or been actively suppressed by various agencies and individuals intent on nurturing as substantial population of ailing people for the purpose of profiting from the treatments they would require.

As awful as this may seem, it is unfortunately the sad truth. And even more unfortunately, this is not only historical as in the case of this well documented 1921 action plan by the US government, FDA and AMA for an influenza vaccination campaign to quickly and effectively spread disease across the country and greatly stimulate the need for medical attention and case as a means to generate profits from the associated expenses, but this continues to this day. The essential conclusion to draw from this is that it is we who must care for ourselves, our children, our family members, and our friends. And to do this, it is again we who must first learn and then teach our children and each other how to best do it. This is what I strive to do and what I strive to share with you.

If you think this article could be useful to others, please ‘Like’ and ‘Share’ it.

Reversing diabetes: a four-week programme

The key factors of the process of reversing diabetes are: dropping blood sugar concentration and keeping it low, dropping insulin concentration and keeping it low, and alkalising the blood, fluids, tissues and organs—especially the pancreas, to eliminate accumulated acids and reverse the physiologically debilitating effects of chronic acidosis so common to diabetes.

We have examined both the process of developing and that of reversing diabetes in several previous articles. Now, we present a detailed four-week programme to put things into practice, begin recovering correct metabolic function, and get you on your way to ridding yourself of diabetes, if this happens to be a condition from which you are already suffering, towards which you are moving, or simply want to make sure it never develops.

As you will see, beyond the manipulation of the biochemistry through what is consumed, there are in addition several tweaks that are employed to ensure the best possible response to and outcome of the programme. These have mostly to do with timing: when we do things, when we drink, and when we eat. But also include important supplements (in addition to other ones you are taking like B12, ubiquinol, etc); as well as physical exercise, and specific types of exercise done under specific conditions.

The programme is constructed based on a four-week period because this is the amount of time that is needed, in the majority of cases, for the hormonal system to rebalance itself around the much lowered insulin levels, and for the cells and metabolism to regain insulin sensitivity and switch from using glucose and breaking down muscle tissue to satisfy energy needs, to instead use primarily fat, and naturally, as we would expect, the fat stored in the body’s adipose tissues throughout, which means sub-cutaneous—the fat that sits under the skin, intra-abdominal—the fat that is between the various digestive organs in the abdomen, and even the fat that is stored inside the tissues of organs like the liver and heart, and in the muscles themselves.

It is very important to understand, however, that even though the startup programme lasts four weeks, it is a transition period and a complete re-education that marks the beginning of a different way of doing things in order to first allow the body to heal itself and for you to regain your health, and then to maintain and refine this state of health over the course of the rest of your life.

It is also very important to understand that what leads and has led you to a diabetic or pre-diabetic condition are factors related primarily to diet and lifestyle, which if adopted by most will cause similar metabolic dysfunction, and obviously, if adopted anew following this four week programme will inevitably lead back to diabetes, and all that much faster for those whose system has already been compromised by the years and decades that led to this metabolic dysfunction in the first place.

Therefore, you must absolutely understand that this is a four-week programme intended to correct major imbalances and dysfunction and get you on your way to reversing your diabetes and tuning your metabolism to efficiently run on fats as the primary cellular fuel. But that it is also intended to re-educate and teach you a completely new way of doing things on a daily basis in order to empower you in knowing what to do to be and remain in perfect health, why you do what you do, and why it works on a physiological and biochemical level.

Lastly, because of its strict timing and numerous elements throughout the day on a very regular schedule, you have to make this programme a priority, and, ideally, make it your primary activity during this period. You will probably find it close to impossible to follow if you are trying to maintain other demanding and time consuming activities like a full time job at the same time. So, just take a break from everything else, and concentrate on your health for a month. Afterwards, once many of these new ways of taking care of yourself have become more habitual, you will find it far easier to maintain a similar routine while working and doing other things simply because it will be far more natural for you.

The first five days

Background

For maximal effectiveness, we start with a period of intensive cleansing and alkalisation during which the key nutritional element is fresh juice of green vegetables, and the sources of calories are restricted to coconut oil, coconut milk, coconut flesh and milled chia seeds. Like a traditional juice cleanse, everything that is consumed is raw and therefore living, enzyme rich, and easily absorbed with minimal digestive stress; and nothing is acid-forming and acidifying, for this would defeat one of the fundamental purposes of the healing protocol which is essential to restore correct pancreatic function.

Highly unlike a traditional juice cleanse, however, there are virtually no simple sugars consumed and entering the bloodstream, and there is a significant amount of fat, almost all derived from coconut oil. This serves several purposes: it provides the metabolism a perfect fuel for cellular function that is easily broken down and generally not stocked away in fat cells; it enhances the production of ketone bodies necessary to fuel the brain in the absence of glucose, at the same time helping heal and repair the brain by promoting the evacuation of plaques from cerebral arteries and thus increasing blood flow to these starved brain cells; it maximises the absorption of the rich array of minerals, antioxidants and phytonutrients in the green juices; and finally, but also importantly, it very effectively suppresses hunger.

During this period the body will quickly and efficiently make the metabolic transition from using exclusively glucose as is always the case in diabetics and insulin resistant individuals, to burning fat reserves as the cellular fuel of choice; significantly decrease the level of systemic inflammation and release several kilograms of the water that is retained under conditions of chronic inflammation and insulin resistance, in great part responsible for hypertension, swelling of the joints and extremities, and poor blood circulation; thoroughly alkalise, cleanse and begin to rejuvenate, heal and repair the vital digestive organs: the stomach and intestines, and the kidneys, pancreas and liver; alkalise the blood and eliminate large amounts of accumulated acids stored throughout the body in the joints, soft tissues and muscles.

All of these processes are very physiologically tiring. For this reason it is important to rest in the afternoon, and have long nights of deep sleep every night. Hence, only walking is recommended as a form of exercise during this period, ideally in the morning (between 9:00 and 10:00) and in the evening after the last meal (anywhere between 20:00 and 22:00).

Detailed schedule

Here is what and when to eat and drink during this period (times can be adjusted slightly according to sleep patterns):

8:00-9:00 (or upon getting out of bed) – Water and Mg oil

  • Put on Mg oil all over the legs, arms, chest and abdomen, shoulders and back (as best you can). Leave on for at least 30 minutes before showering.
  • Large glass of plain water (400-500 ml)
  • Supplements:
    • Proteolytic enzyme complex (3; Baseline Nutritionals)
    • Spirulina (3; Nutrex) / Chlorella (5; Healthforce Nutritionals)
    • Tulsi extract
    • Lugol’s iodine solution (in water; 5%: 6 drops, 15%: 2 drops)
    • ATP Cofactors (Optimox)
    • Probiotics (Prescript-Assist)

9:30-10:00 – Green juice and chia seeds

  • Glass of water with milled chia seeds (1 flush tablespoon)
  • Green juice with coconut oil (1 tablespoon, melted and emulsified with hand-held blender)
  • Supplements:
    • Niacinimide (2)
    • Turmeric (powdered (2) or extract (1))
    • Cinnamon (powdered (2) or extract (1))
    • Krill Oil (2; Mercola)
    • Astaxanthin (Nutrex)
    • A/D/K2 (DaVinci Laboratories)
    • Zinc (MegaFood)

11:30-12:00 – Lemonade

  • Lemonade: 1 medium (or 2 small) pressed lemon, 1/2 tsp salt, 2 mini spoon stevia in 500 ml of water.
  • Vitamin C: 1/2 tsp with small amount of water, stir until fizzing stops, fill small glass half way. (Ultimate Ascorbate C Powder by Source Naturals mixed with highest quality, food grade, powdered sodium bicarbonate in ratio 2:1)

12:00-12:30 – Salty veggies

  • Cucumber, kohlrabi or celery with salt
  • Supplements:
    • Enzymes (3)
    • Spirulina (3) / Chlorella (5)
    • Tulsi
    • Lugol’s
    • ATP Cofactors

13:00-13:30 – Green juice and coconut milk pudding/ice cream

  • Green juice without coconut oil
  • Coconut milk pudding (blueberry, raspberry, blackberry or cacao-chia)
  • Supplements:
    • Niacinimide (2)
    • Turmeric (powdered (2) or extract (1))
    • Cinnamon (powdered (2) or extract (1))
    • Krill Oil (2)
    • Astaxanthin
    • A/D/K2
    • Zinc

14:00-15:30 – Sleep

Sleep (very important for the first 5 days that will be very tiring for the body in terms of cleansing and repair)

16:00-16:30 – Water

  • Large glass of water
  • Supplements:
    • Enzymes (3)
    • Spirulina (3) / Chlorella (5)
    • Probiotics

16:30-17:00 – Green juice and chia seeds

  • Glass of water with milled chia seeds (1 flush tablespoon)
  • Green juice with coconut oil (1 tbs melted)
  • Supplements:
    • Niacinimide (2)
    • Turmeric (2)
    • Cinnamon (2)

18:00-18:30 – Lemonade

Lemonade and Vitamin C (as above)

19:00-19:30 – Salty veggies

  • Glass of water with milled chia seeds (1 flush tablespoon)
  • Cucumber, kohlrabi or celery with salt
  • Supplements:
    • Enzymes (3)
    • Spirulina (3) / Chlorella (5)

20:00-20:30 – Green juice and coconut macaroons

  • Green juice without coconut oil and coconut macaroons (but not with cacao).
  • Supplements:
    • Niacinimide (2)
    • Turmeric (2)
    • Cinnamon (2)

22:00-22:30 (just before bed) – Psyllium and charcoal

  • Large glass of water with psyllium husks (2 rounded teaspoons, mixed and allowed to swell for a few minutes)
  • Supplements:
    • Charcoal (Source Naturals)
    • Valerian root extract (Bluebonnet Nutrition)
    • NightRest (Source Naturals)

Beyond the first five days

Background

At this stage, the body will have undergone a radical transformation biochemically and physiologically from the inside out. Most noticeable will be the loss at least 4-6 kilos of water (about 2 kg) and fat (about 2-4 kg), with the accompanying feeling of being much lighter and thinner at the waste with a deflated abdomen and gut. The digestive system will have experienced a very effective cleansing and bowel movements will be noticeably more regular and quite different in texture, smell and sensation. The smell and volume of both urine and sweat will have evolved markedly during this period. And all the vital digestive organs will have been given a powerful boost and rejuvenation, but this cannot really be felt. You should as mindful as possible of all of these details and everything else you can notice over the course of the first five days. This will give you a much deeper appreciation of the process and of its importance in regards to your moving towards better health.

We can now continue with a regime that includes two green juices per day instead of four, dropping the afternoon green juice, and replacing the evening green juice by a large green leafy salad with small amounts of nuts, seeds or fish (sardines, anchovies or wild smoked salmon, for example). We will also reduce quantity and frequency of supplements.

In addition, we will introduce a component of exercise that is absent in the first five days, which will greatly enhance the body’s response to the new regime and metabolic environment. The exercise will take the form of fast walking with very light weights for strengthening the shoulders and arms, Pilates workouts to develop strength in the core muscles (abs and back) for postural balance, high intensity interval training coupled with resistance as well as cross-fit training with weights to increase cardiovascular and metabolic efficiency, fat and glucose utilisation, muscle mass, done density, and tendon and ligament strength and flexibility.

Detailed schedule

8:00-9:00 (or upon getting out of bed) – Water and Mg oil

  • Put on Mg oil all over the legs, arms, chest and abdomen, neck, shoulders and back (as best you can). Leave on for at least 30 minutes before showering.
  • Large glass of water (400-500 ml)
  • Supplements:
    • Proteolytic enzyme complex (3)
    • Spirulina (3) / Chlorella (5)
    • Tulsi extract
    • Lugol’s solution (in water; 5%: 6 drops, 15%: 2 drops)
    • ATP Cofactors
    • Green tea extract
    • Green coffee bean extract
    • Probiotics

9:00-9:45 – Walk

Fast walk with 1 kg weights in each hand, using them to do shoulder rotations, biceps curls and triceps extensions while walking.

10:00 – Green juice

  • Glass of water with milled chia seeds (1 flush tablespoon)
  • Green juice with coconut oil (1 tbs, melted and emulsified with hand-held blender)
  • Supplements:
    • Niacinimide (2)
    • Turmeric (powdered (2) or extract (1))
    • Cinnamon (powdered (2) or extract (1))

11:30-12:00 – Lemonade

  • Lemonade and Vitamin C (as above)

12:00-12:30 – Salty veggies

  • Cucumber, kohlrabi or celery with salt
  • Supplements:
    • Enzymes (3)
    • Tulsi
    • Lugol’s
    • ATP Cofactors
    • Green tea extract
    • Green coffee bean extract

13:00-15:00 – Workout

  • Resistance and high intensity interval training on Mondays
  • Pilates on Tuesdays, Wednesday and Thursdays
  • Cross Fit training on Fridays
  • Rest on Saturdays and Sundays

15:00-:15:30 – Gren juice and coconut milk pudding (or ice cream)

  • Green juice without coconut oil
  • Coconut milk pudding or ice cream (blueberry, raspberry, blackberry or raw cacao and chia)
  • Supplements:
    • Niacinimide (2)
    • Turmeric (2)
    • Cinnamon (2)
    • Krill Oil (2; Mercola)
    • Astaxanthin (Nutrex)
    • A/D/K2 (DaVinci Laboratories)
    • Zinc (MegaFood)

15:30-16:30 – Sleep

Sleep (highly recommended; optional after the first five days)

16:30-17:00 – Water

  • Large glass of water
  • Supplements:
    • Enzymes (3)
    • Spirulina (3) / Chlorella (5)
    • Probiotics
    • Green tea extract
    • Green coffee bean extract

17:30-18:00 – Lemonade

Lemonade and Vitamin C (as above)

18:00-18:30 – Salty veggies

Cucumber, kohlrabi or celery with salt

19:00-20:00 – Green juice, salad and coconut macaroons

  • Green juice without coconut oil (then wait 30 minutes)
  • Green leafy salad with oil and salt (no vinegar), and small amount of either walnuts, anchovies, sardines or salmon (smoked, grilled or pan fried)
  • Coconut macaroons for dessert.
  • Supplements:
    • Niacinimide (2)
    • Turmeric (2)
    • Cinnamon (2)

22:00-22:30 (just before bed)

  • Supplements:
    • NightRest
    • Valerian root extract

Concluding remarks

This is a programme designed for reversing type II diabetes, and will, without any doubt, do exactly this. What might vary from one person to another is really only the time that will be required to recover ideal insulin sensitivity.

It is important to appreciate, however, that it would be just as effective in treating any kind of degenerative condition like arthritis, but also atherosclerosis of the coronary or cerebral arteries, and arteriosclerosis due to the accumulation of calcium in the tissues; kidney or liver disease but also pancreatic fatigue or dysfunction; stomach and peptic ulcers, but also candida overgrowth and infection, as well as leaky gut syndrome; and of course, probably the most fearsome of them all—cancer.

Why? Because all health problems and disease conditions stem from biochemical and hormonal imbalances, and metabolic and physiological dysfunction. Therefore, in order to either prevent or correct any one problem, all problems must be prevented and corrected. For some of us—very few of us indeed—this is plainly obvious. It is, however, also obvious that this understanding is definitely absent—conspicuously and painfully absent—from modern conventional health care, no matter what it is intended to treat and no matter where we look.

Hence, it is my hope that this programme will not only help diabetics and pre-diabetics permanently reverse their diabetes and all the associated problems related to the underlying metabolic dysfunction, but also help all those who wish to treat whatever health concern they may have, as well as those who wish to prevent any such health problems from developing.

The only way to develop and nurture optimal health is for every cell, organ and system of the body to function optimally. Therefore, this is what we must do, and that’s the bottom line. Good luck with the programme. Naturally and as usual, you are welcome to post you comments, questions and observations, especially those from your experience with the programme. I would be very happy to hear from you.

If you enjoyed reading this article, please click “Like” and share it on your social networks. This is the only way I can know you appreciated it.

Reversing diabetes: understanding the process

The fundamental problem, the cause of all the complications associated with diabetes, is the chronically elevated glucose and insulin levels. Independently of the fact that each individual, each one of us, has a different tolerance to carbohydrates, a different metabolic response to the presence of glucose and insulin in the blood, there are basically only two ways that blood glucose can be elevated: the first is by the consumption of sugar or starch that finds its way into the bloodstream through the intestinal wall; the second is by the stimulation by stress hormones of liver glucose production whereby the glycogen reserves are broken down and the resulting glucose released into the blood. Therefore, in order to most effectively bring down chronically elevated blood sugar levels, it is essential to eliminate insulin-stimulating carbohydrates, but it is also essential to eliminate chronic stress.

The sugar

The vast majority of the millions of type II diabetics that constitute the body of what is now generally considered to be a diabetes epidemic in many western countries, have developed the condition primarily from the consumption of dietary insulin-stimulating carbohydrates, from eating high-sugar and high-starch diets over the course of decades. The process of growing insulin resistance due to chronic consumption of carbohydrates is described in several other posts (like, for example, We were never meant to eat simple or starchy carbohydrates, A diabetic’s meal on Air France, and Cure diabetes in a matter of weeks). It is for this reason that the same vast majority of type II diabetics responds extremely well to the elimination of these carbohydrates from their diet, whereupon glucose levels drops, insulin levels drop, the cells gradually regain insulin sensitivity, and the tissues and organs gradually recover from years or decades of the toxic environment created by continuously being exposed both to glucose and insulin. Naturally, the recovery process depends intimately on how long and how bad things were before implementing these dietary changes, but it happens in more or less the same way in every person.

The stress

The tendency, in many western societies, especially in North America, to create and generate in all sorts of ways very high levels of stress in most spheres of activities in our life, and, unfortunately, also thrive on this stress, often for years or even decades, in order to be highly productive, successful, and therefore important, or at least, make ourselves feel and believe that we are, is extremely bad. This, compounded with the fact that most of our standard western diets are very high in insulin-stimulating carbohydrates, makes the evolution towards of type II diabetes faster, more pronounced, and much more harmful. As a consequence, there is without a doubt a non-negligible fraction of diabetics that suffer from both a high intake of sugary and starchy foods, as well as high stress levels.

In the extreme, however, it is definitely possible to develop diabetes uniquely or primarily due to chronically high levels of stress. The most important, and indeed, very important difference between elevating blood sugar through diet or as a consequence of stress hormones, is that the former is naturally corrected by the secretion of insulin, which helps put aways the sugar either as glycogen or as fat, whereas the latter, the presence of high levels of stress hormones, simultaneously induces insulin resistance in order to keep the glucose in circulation as long as possible. This makes perfect sense from an evolutionary standpoint because under stress, under a fight or flight situation, we need lots of glucose in the blood and we want it to stay there to allow us to respond physically to whatever needs to be done: to run, jump, climb, fight, survive. The problem is that our high levels of stress are not only chronic, but they are not associated with a situation in which we need to have access to high levels of sugar in the blood in order to respond to the stressor physically with our muscles. And so, glucose remains high and circulates, insulin remains high but is not effective, and from this, all our blood vessels, tissues and organs get damaged: glycated from the glucose, oxidised from the free radicals, and literally corroded by the insulin.

This clearly implies that chronically high levels of stress are far worse than a high carbohydrate diet, and explains in no uncertain terms why high-stress professionals—even low-carb eaters—can not only suffer from chronically elevated blood sugar levels and the full array of damaging consequences, but also develop diabetes, and almost inevitably, heart and artery disease, because they all come from the same place: high stress leads to high levels of cortisol and other stress hormones; high levels of stress hormones lead to high glucose and insulin resistance no matter what is eaten because it comes from the liver; high glucose levels and insulin resistance leads to artery disease which leads to heart disease, and it also leads to type II diabetes. This is why, for those high work volume and high stress high-strung high-achievers, it is essential to eliminate all insulin-stimulating carbohydrates, but it is crucial to significantly reduce, and ideally, eliminate chronic stress. (We have looked at many of the physiological effects of stress in The kidney: evolutionary marvel and in At the heart of heart disease.)

The physiological consequences

As every diabetic knows, or at least should know, the consequences or complications associated with the condition of diabetes are horrific. What is very unfortunate is that it appears as though many doctors do not understand the biochemical and physiological connections and chains of  reactions and responses that develop and grow more sever over time as a consequence of the underlying chronically elevated blood sugar and insulin levels (as you may remember from your reading of Why do diabetics have high blood pressure?). What happens in the body when levels of blood sugar and insulin resistance stay high? Let’s follow this through:

High blood pressure, atherosclerosis and heart disease

The most immediate consequences are the rise in blood pressure and increased damage to blood vessels from glycation: the elevated levels of glucose that the kidneys have evolved to keep in circulation causes a rise in osmolarity (blood concentration), which the kidneys try to counter by retaining water in order to keep the blood from getting too concentrated. Since blood pressure is mostly a function of the amount of water in the blood, this causes the pressure to rise. Because glucose is meant to remain in minimal circulating concentrations or otherwise be quickly cleared from the bloodstream by pancreatic insulin shuttling it into cells, long-lasting elevated sugar concentration leads to the glycation of tissues, which is the damage of protein or fatty structures of the cells due to the glucose molecules “sticking” in the wrong places and in the wrong way. This, in combination with the higher blood pressure, is the perfect recipe for much increased damage to the blood vessels, especially the large arteries in which the pressure is greatest, the increased production of cholesterol and lipoproteins for cholesterol transport and damage repair, and the consequent plaque buildup termed atherosclerosis, which eventually (sooner than later) leads to artery disease, heart disease, and heart attacks from the occlusion of vessels bringing blood to the heart muscle (the coronary arteries).

Kidney disease

Even though it is the kidney that regulates the blood pressure and retains water in order to keep the blood from getting too concentrated with the increasing concentration of glucose, the higher blood pressure puts great strain on all of its micro filtering units, the nephrons, whose function is to filter out acidic metabolic waste from the bloodstream and get rid of it through the urine. The nephron works optimally under optimal conditions, but optimal for it, which means ideal blood pressure: not too low, but especially, not too high. It’s a self-regulating system in that if we are relaxed and at rest, then breathing is slow, heart beat is slow, blood circulation is slow, blood pressure is low and the kidneys are under little strain. As we get moving, through exercise, for example, then breathing is faster, heart beat is faster, blood flow is faster, blood pressure is higher, and the kidneys filter a larger volume of blood per second in order to eliminate as much of the acid that is building up from the activity and that needs to be eliminated in order for the muscles to continue working in ideal conditions.

With chronically high blood pressure, the kidneys are continually under stress and the nephrons get damaged. However, because there are millions of nephrons in each of the two kidneys, and it has been estimated that we can live with only 1/3 of the nephrons in only one of the two kidneys, this problem of the gradual deterioration of kidney function is not really considered as a big issue until the kidneys fail (or little time before), at which point it is far too late, and the situation is irreversible.

In addition, insulin resistance—to any degree—promotes the break down of muscle tissue, because as soon as sugar levels drop after a few hours after a meal or snack, during the night is the most apt example, since the cells cannot use fats for energy, the muscle tissue is broken down and constituents of its proteins made into glucose. This leads to chronically high levels of circulating creatinine that, as a metabolic waste product, must also be filtered out and eliminated by the kidneys. This happens in everyone with insulin resistance, and the amount of muscle breakdown is a function of the degree of insulin resistance. In the case of extreme insulin resistance as is seen in type II diabetics, the process is far more pronounced. The excessive stress on the kidneys inevitably leads to deterioration, nephron dysfunction, and eventually to failure. (You can read more about kidney function in The kidney evolutionary marvel.)

What makes things even worse is that most diabetics/heart disease sufferers have elevated lipoprotein (and cholesterol) levels due to the excessive inflammation and speed at which tissue damage is taking place in the blood vessels and all over the body. This, as you all know, has been wrongly interpreted and widely promoted as a major risk factor for heart attacks. The “treatment” of choice for these patients are a lifelong prescription for statin drugs. Very unfortunately, not only do statin drugs not confer any health or longevity benefits, but they accelerate the speed at which muscle breaks down, causing even greater amounts of creatinine to make its way into the bloodstream, and thus creating a heavy additional load on the kidneys. Is it any wonder that the rise in kidney disease closely reflects the rise in diabetes but also in statin consumption? If you’ve been taking statins, don’t get overly worried: physiological degradation is a slow process, and it is rarely too late to make the intelligent choices and changes that will help stop and reverse the disease process, and in time allow the body to heal itself.

Systemic acidosis

The way in which the kidney regulates blood pressure upwards is by secreting different hormones that prevent water from being eliminated, that thicken the blood, and that contract the blood vessels. In most people, the majority of which is chronically dehydrated, there is already a shortage of water and therefore a dehydration response by the kidneys; the elevated sugar concentration makes this far worse, of course. And under dehydration conditions, the means by which the kidney can retain even more water, as much water as it can, is by increasing the concentration gradient in the interstitial medium through which the nephron passes in order to pull as much water out of the filtrate as possible.

Increasing the concentration gradient is done by keeping and concentrating sodium and uric acid. It is more important to retain water than to eliminate uric acid, because water is primordially important for all body functions. Consequently, urea and uric acid levels rise, gradually but consistently over time. Because acid cannot accumulate in the blood, whose pH must absolutely be kept pretty much exactly at 7.4 (7.35-7.45), but because, at the same time, it cannot be eliminated by the kidneys under the given circumstances, it is stored away in the tissues all over the body: joints, ligaments, tendons, muscles and organs. Chronically high levels of uric acid in the blood lead to the condition known as gout. The buildup of acid in the tissues leads to pain, inflammation, arthritis, cartilage breakdown, bone demineralisation and osteoporosis, and a slew of other undesirable consequences, including increased susceptibility to all forms of infections: yeast, viral and bacterial, and severely depressed immunity. (You can read more about acidosis and alkalisation in A green healing protocol, Detoxification, and Such a simple and yet powerful natural anti-inflammatory.)

Maybe the most critical point about acidosis in how it relates to diabetes is that the pancreas and its precious beta cells, those that produce the insulin, are extremely sensitive to pH, and simply cannot function when the blood and cellular environment is acidic. The cells simply stop functioning because of the overload of acid that is not excreted and not neutralised. This makes the pancreas more and more dysfunctional over time, and eventually leads to exhaustion and the complete inability to secrete insulin or do any of the other functions that it is intended to perform. Something very similar happens in the liver, and, in fact, everywhere else, when chronic acidosis defines the internal environment of the body.

Pancreatic exhaustion

The distinction between type I and type II diabetes is usually highlighted by calling the first insulin-dependent diabetes, and the second insulin-resistant diabetes. Type I diabetics are usually identified and diagnosed as children or young adults because their pancreas does not produce insulin, and are then “treated” by having to inject themselves insulin after they eat for the rest of their lives. Naturally, over time, from the continual and usually excessive exposure to insulin, their cells become insulin-resistant, and they subsequently develop all the same problems as type II diabetics, whose condition is, in a way, exactly the opposite, in the sense that they suffer from chronic hyper-insulinemia, because their pancreas that senses the elevated glucose concentration in circulation, produces more insulin in order to clear it out and store it away. The problem is that the cells are not sensitive to the presence of insulin, and therefore do not take in the sugar. The pancreas is then forced to produce and secrete more insulin, and on it goes. Amazingly, type II diabetics are also “treated” by insulin injections, which increase insulin levels even more, and increase insulin resistance even more, obviously making the situation far worse. Eventually, the pancreas of the type II diabetic gets completely exhausted, and loses the ability to manufacture and secrete insulin. At this point, the type II becomes a kind of type I. Interesting how this goes, isn’t it.

The pancreas’ main function is not to secrete insulin, even though in our diabetic-centric worldview it is certainly considered as such. This is one of its functions, but not the most important. By far the most essential is the production and secretion of enzymes, the specialised proteins that break down foods but also do everything else that needs to be done, especially tissue building and repair throughout the body. The third essential function of the pancreas is the concentration and secretion of sodium bicarbonate in the small intestine following the movement of the pre-digested chyme from the stomach into the small intestine. This is also extremely important because all absorption and digestion in the intestine must take place in an alkaline environment, compared to the acidic environment required in the stomach when protein is present. Pancreatic exhaustion from the over-production of insulin for years on end, therefore spells disaster on many more fronts than just insulin and glucose metabolism. It spells disaster for all digestion and absorption processes, and all enzyme regulated activities, which basically means everything, really. This is very serious.

Liver dysfunction

The liver does an amazing amount of vital work, most of it incredibly complex. This includes filtering the blood from all sorts of toxins, both biological and chemical in nature, and breaking those down for elimination; it includes the manufacture of cholesterol and lipoproteins, vital for survival, but the details of which are so intricate that they are still not completely understood after a century of study; it includes the transformation of excess glucose into glycogen and into fat for storage; and in includes the manufacture of glucose from liver-stored glycogen to continually adjust the levels of glucose in the circulation depending on the body’s needs, or more specifically, on the hormonal and biochemical environment. The distinction may appear subtle, but it is quite important in the sense that it is really the hormones and biochemistry of the blood that regulates the function of most tissues and organs, especially those of the vital glands like the liver, pancreas and adrenals, and there is hardly anything more disruptive and unbalancing to the hormonal and biochemical makeup than chronically elevated glucose, stress hormones and acid levels.

Under such conditions, the liver must manufacture an inordinate amount of glucose from the glycogen stores that it itself must also replenish, but also from the broken down muscle tissue. At the same time it converts as much as it can of the glucose into fat for storage, but unfortunately, insulin resistance makes it impossible for the triglycerides to be used, and they are therefore left in circulation for longer than they should before eventually being stored in our fat cells. To top up the list, the free-radical and glycation damage to the vessels and tissues require the liver to also manufacture an inordinate amount of cholesterol and lipoproteins in an attempt to repair these damaged cells, which is no small feat, (you can read more about cholesterol and lipoproteins in But what about cholesterol? and in Six eggs per day for six days: cholesterol?). All of these processes are perfectly natural. However, they are not meant to be running in overdrive for years on end. It is no surprise then that imposing upon the liver to cope with this, eventually leads to dysfunction, deterioration, exhaustion and failure.

Towards a working solution

This is definitely not the end of the list of the complications and physiological consequences that develop from chronically high circulating glucose and insulin levels, but they are some of the most important. Also, it is essential to understand the process by which these consequences first arise and then grow in severity and into the disease process over time. It is, however, infinitely more useful to know what to do in order to maintain a biochemical and hormonal environment in which none of these various dysfunctions and complications can arise if they haven’t yet, or how they can be stopped and reversed if they have.

It shouldn’t be surprising that these are the same, and that they are keys to any optimal health plan, simply because the cells, tissues and organs that make up the human body function, or rather, should function in the pretty much the same way in everyone, allowing for small differences in some of the details. For example, the fact that different people have different tolerances to carbohydrates does not change anything to the consequences of chronically elevated glucose levels on physiological function. It only changes the details relating to the thresholds and time scales involved in developing the same problems. The same goes for vitamin D: the fact that different people require different amounts of vitamin D in order to remain healthy does not in the least alter the basic fact that virtually all complex living creatures depend on it for life. So, yes, everyone is different, but, at the same time, everyone is the same.

No sugars, no starches, no dairy

The first step to take is to eliminate from the diet foods that cause glucose and insulin levels to rise. For this, we must

  1. Eliminate all simple sugars: that’s basically anything that tastes sweet, including sweet fruit, because all simple sugars will elevate blood glucose levels almost immediately after consumption;
  2. Eliminate all starchy carbohydrates: that’s all grains and grain products (at least 90% carb), beans (typically more than 70% carb), potatoes (virtually 100% carb), and other starchy veggies like sweet potatoes, yams, taro, etc, because the starches they contain are broken down to glucose by enzymes in the digestion process; but also sweet root vegetables like carrots and beets, which are just full of simple sugars (you’ll know this if you’ve ever had carrot or beet juice?)
  3. Eliminate dairy: that’s all milk products, which, even those low in sugars like hard cheeses, cause a rise in insulin levels. Besides, most people are allergic or intolerant to dairy products, whether they are aware of it or not.

And aside from just glucose and insulin levels, as we discussed in At the heart of heart disease, insulin-stimulating carbohydrates are highly inflammatory, triggering more than 300 inflammatory pathways. So, excluding them from our diet not only brings about plenty of positive metabolic and physiological changes, but it is, as far as I am concerned, a requirement to make those positive changes happen.

Drop the stress

For those people to whom we referred to earlier that suffer mostly from the chronically elevated stress hormone levels, it is crucial to eliminate the causes of stress, ensure long hours of high quality sleep, and incorporate exercise and activities that effectively reduce stress levels, as well as supplements that can help with that. Obviously, the most important sources of stress for most professionals are psychological ones. But what is also well established is that the level of stress that is experienced (i.e., the amount of stress hormones secreted and in circulation) depends entirely on each person’s outlook and attitude. Therefore, it is this—the attitude and outlook—that are the most influential factors in generating or relieving stress on a daily basis.

Having said this, it is also obvious that going to a remote holiday house on sandy beach without access to phone or internet communications, and making a point of simply relaxing, going for walks, swimming in the sea, reading good books, watching good films, taking naps, eating healthfully and sleeping long and soundly every night, is inherently far more conducive to eliminating stress than the usual school year and work day conditions. What we must find a way to do is to function well in all circumstances with minimal stress, and most importantly, without chronic stress. It is chronic stress that is the problem; not relatively short periods of high stress. And stress, it shouldn’t be surprising, is also happens to be extremely acidifying (haven’t you ever noticed the strong, acidic smell of underarm stress sweat?).

Very helpful in this is taking Tulsi in the morning and at lunchtime (only during the day), and valerian root before bed. But exercise, conscious relaxation, and modifying outlook and attitude towards a more open and relaxed position are definitely most important.

Lower blood pressure

Lowering glucose levels will automatically lower blood pressure. Lowering stress will also automatically lower blood pressure. Biochemically though, the most important muscle relaxant—and this most definitely applies to the smooth muscle cells that line the blood vessels—is magnesium. Therefore, magnesium baths, oil and oral supplementation is essential. On the other hand, calcium is contractile and unfortunately, much more present in the foods we eat. Therefore, most of us are magnesium deficient but also over-calcified. Hence, minimising calcium intake is also very important. (You can read more about these topics in Minerals and bones, calcium and heart attacks, and in Why you should start taking magnesium today.)

Proper mineral balance, especially sodium and chloride, are essential for blood pressure regulation. Eating plenty of unrefined sea salt with meals (and with drinks) is also crucial. Naturally, we seek balance, and salt intake has to be balanced with water intake, and this leads to optimal kidney function. (You can read more about water, salt and physiological function in How much salt, how much water and our amazing kidneys, Why we should drink water before meals, and in Water, ageing and disease)

Support the kidneys

The kidneys want to maintain optimal blood pressure; regulate water, sodium and mineral content of the blood; and clear out metabolic wastes, mostly uric acid. To have them do what they are trying to do as best they can, we must very simply provide plenty of water, plenty of unrefined salt rich in sodium and all the other essential minerals, plenty of alkalising sources in drink and food, minimise glucose levels and minimise creatinine levels. The importance of alkalising the body intensely at first and continuously thereafter cannot be overstated with regards to the proper function of all the vital organs discussed here, and everything else really: every cellular process and every enzymatic action; everything depends on this.

Rejuvenate the pancreas

The pancreas senses and responds to glucose in the blood by manufacturing and secreting insulin. It responds to the movement of food from the stomach to the intestines by manufacturing and secreting sodium bicarbonate and digestive enzymes. To rejuvenate the pancreas, we need to not only give it a break, but help it recover. For this, we need to minimise glucose levels in the blood, and thereby minimise the need for it to manufacture insulin; maximise intake of enzymes to minimise the need for it to produce them; and, especially in light of what we discussed under acidosis, we need to maximise alkalisation, including through oral and transdermal absorption of sodium bicarbonate and magnesium chloride, with a focus on chlorophyl and chlorophyl-rich foods and drinks.

Cleanse the liver

The liver’s most taxing function is the breakdown of toxins (all substances foreign and dangerous to the body). Another taxing function of the liver is the manufacture and recycling of cholesterol and lipoproteins that, as we said earlier, are in production overdrive because of the excessively fast free-radical and glycation damage to the lining of the blood vessels, as well as the damage these cause everywhere else in the tissues of the body, accompanied by the chronic systemic inflammation this leads to (you can read more about systemic inflammation in Treating Arthritis and At the heart of heart disease.)

To help the liver, we must therefore first stop ingesting chemically manufactured medications, and we must eliminate sources of toxins and chemicals from the things we eat and drink; from the air we breathe, especially from those toxic cleaning products we use; and from all the chemicals we absorb through the skin in soaps, shampoos, lotions and creams. Second, we eat and drink to minimise inflammation and internal tissue damage, therefore minimising the strain of excessive manufacture of cholesterol and lipoproteins. And third, we must take regular toxin cleansing and alkalising baths with sodium bicarbonate and magnesium chloride. This simple therapy is the most effective means of detoxifying the body from chemicals and toxins or all kinds, including the most notorious radioactive isotopes that can make their way into our bodies from nuclear weapons, spills and power plant accidents through the air, water and food. Here again, chlorophyl and chlorophyl-rich foods and drinks are essential.

In conclusion

The basic conclusion is the same as what we have come to whenever we discussed type II diabetes: while it is a devastatingly damaging condition that affects every metabolic and physiological function of the body, it is incredibly easy to prevent, and even after many years of deterioration for the diabetic sufferer, it is relatively easy to reverse the condition and cure the disease, including the beta cells of the pancreas, by understanding the disease process thoroughly, and by adopting an appropriate healing protocol. Here, we have detailed several of the key problems or complications that stem from chronically elevated glucose and insulin levels, with specific discussion of the ensuing dysfunction in some vital organs, and highlighting the crucial importance of considering the effect of stress in addition to the effects of dietary insulin-stimulating carbohydrates.

You might have noticed that a discussion revolving around overweight, obesity and fat metabolism is missing, maybe conspicuously so. This is not an oversight, but a conscious move towards a focus on the underlying causes of the metabolic, hormonal and physiological natures of the disorder instead of the superficial and rather inconsequential repercussions of it that take expression in the form of excess body fat. The only point I want to mention about this is that by correcting the causes of the disorder, excess body fat stores will melt away on their own. Some help from supplements and hormonal manipulation through diet and timing here and there will be useful. But, the point remains that if the body is in optimal biochemical balance, then physiological and metabolic functions will also be optimal, and no excess body fat will remain, no matter how young or old we are, and no matter what our genetic makeup happens to be.

The overview of the basic strategy for preventing and overcoming diabetes should make it clear that what it implies, although in some aspects quite specific and targeted, is very simple in that it relies mostly on drinking clean water, eating unrefined salt and clean foods, especially those that are chlorophyl-rich, eliminating damaging foods, chemicals and toxins, alkalising and detoxifying with sodium bicarbonate and magnesium chloride, and finally, using a number of important supplements to correct deficiencies and restore optimal biochemical balance. In a subsequent post we will formulate a detailed programme that incorporates all of the elements and strategies discussed here in general terms, together with some additional considerations about details like the timing and amount of food, drink, exercise and supplements.

If you enjoyed reading this article, please click “Like” and share it on your social networks. This is the only way I can know you appreciated it.

Why do diabetics have high blood pressure?

This is the question that someone in the audience asked at the end of a presentation on diabetes that I attended a few months ago. Remarkably, the speaker was unable to answer this question. Amazingly, neither could any one of the three medical doctors that were in attendance. I was, naturally, quite shocked by this obvious display of ignorance on all of their part. At the same time, I wasn’t really surprised, and, in fact, relieved to be vindicated in my belief that probably the majority of MDs don’t understand the most basic things about human physiology and metabolic function.

Now, you, on the other hand, you who has been following and reading this blog, might (or even should), I believe, be able to answer that question. But since you’re reading this, and therefore cannot be put on the spot, as was the speaker and those MDs at that presentation, you don’t have anything to worry about if you can’t. And yes, I am going to explain. On top of that, I’ll be as quick as I can about it.

As always, first things first: How is blood pressure regulated? What is it that does the regulating? And why is it important?

Blood pressure regulation is of the utmost importance for the proper functioning of every organ because every cell in the body depends on a properly functioning circulatory system to bring nutrients and carry away waste. Blood pressure is like the voltage that drives current through wires and electronic components: it is a driving force. And exactly like it is for electric and electronic devices, the driving force must be just right: it cannot be higher and it cannot be lower than what it needs to be in every moment depending on what the immediate circumstances and needs happen to be. Therefore, blood pressure regulation is essential for the moment to moment adaptation of every metabolic and physiological function, to the different activities we do, and circumstances we find ourselves in.

The main organ responsible for blood pressure regulation is the kidney. I use the singular because the two kidneys work in the same way. It’s just that their function is so vitally important that there are two of them, most logically for redundancy, as a fail-safe system. I have written at length about kidney function in two articles entitled The kidney: evolutionary marvel; and How much salt, how much water, and our amazing kidneys. By the way, this is what I meant earlier: if you’ve read those, understood and happen to remember a few essential bits, then you would be in a good position to answer the question as to the relationship between diabetes and blood pressure. Here it is in a few words; well, maybe a few paragraphs.

The kidney’s vital role is filtration of metabolic acids out of the blood, and elimination of these through the urine. To do this as best it can, because the first and most important part of the filtration process relies on the separation of the liquid from the solids in the blood, and because this is done through what is a mostly “mechanical” filtering through a membrane as it is in water filters, the kidney must maintain optimal pressure to ensure optimal function of the little filtering units, the nephrons. If pressure is too low, the membrane filtering does not work well. If pressure is too high, the membrane tears or pops, and the filtering units stop working altogether.

The good news is that damaged nephrons can sometimes recover when the conditions are made conducive to it, and that there are millions of them in each kidney. The real bad news is that when they die, they do not come back to life. Another bit of bad news, although some would surely take this as good news instead, is that this process of deterioration of kidney function and death of nephrons takes place gradually but silently over the years and decades of our life. When the consequences of poor kidney function become noticeable or even critical, and we finally go see our MD because we’re not feeling good, or worse, are brought directly to the emergency room, it is far too late, for most of the nephrons are already dead.

And to be perfectly clear on this, if the kidneys fail and we don’t get immediate attention and artificial filtering of the blood through dialysis, we die within hours. This is what is meant by the word vital when qualifying the kidney as such an organ.

As I often highlight, the cells, tissues and organs that constitute the entirety of the body that we erroneously call ours and mistakenly believe this to be the case, do not care about you in the least. They do not know anything about you and never will. They, as all living things, are only concerned with survival and self-preservation. It is for this reason that they continually adapt in all sorts of ways to the environment in which they find themselves: this is the internal environment of the body. And it is for this reason that the kidney regulates blood pressure so accurately and so well when allowed to function as it should.

How does it do this regulating? By very closely monitoring the concentration of the blood and secreting hormones to induce the necessary adjustments. The concentration of the blood is the balance between the amount water and the amount of solutes (things dissolved in the water). Most important is the amount of water, because it gives the blood its volume and thus pressure within the closed circulatory system of somewhat malleable veins and arteries. Of the solutes, the most important is sodium, because it holds and must be held in the highest concentration of all solutes, accounting for about half of the overall solute concentration (140/300 mOsmol/L). But the kidney works to keep the entire spectrum of natural solutes, especially the minerals, each in its optimal physiological range.

Two nutrients that the kidney works to keep in circulation are proteins and glucose for the obvious reason that they are essential to proper physiological function, and, evolutionarily speaking, rather rare to come by and thus precious. As they are also solutes circulating in the blood plasma, each contributes to the total concentration. And this is where we get to the point:

As glucose concentration rises, the total concentration of the blood rises accordingly. For insulin-resistant diabetics whose cells have lost their sensitivity to insulin, and with that their ability to take up glucose from the blood, there is no outlet for this excess glucose that just keeps on rising in concentration. But unlike what the kidney does in regulating the concentration of sodium and other minerals by excreting any excesses through the urine, glucose is kept in circulation, as much as possible.

After some time, whether because the concentration is through the roof, because the kidney cannot anymore function as it should to keep the glucose in the blood, or both, glucose spills into the urine. This is how, in fact, it was discovered that all of the symptoms that we described as the condition of diabetes are due to a dysfunctional metabolism of glucose: because the urine of diabetics was sweet smelling and sweet tasting. (What dedicated MDs we had 100 years ago! Do you think your MD would taste your piss today to make sure you’re not sick?).

In response to this, to maintain the concentration as close to 300 mOsmol/L as possible, the kidney retains water to dilute the blood from the excessive glucose. This makes the blood volume increase and therefore also the blood pressure. This is why diabetics have high blood pressure. This is also why diabetics have very high incidence of kidney disease. This is also why diabetics have water retention and circulatory problems.

But this is also why they suffer from a lot more strokes, heart attacks, Alzheimer’s, dementia, arthritis, why they have elevated cholesterol, why they age so much faster, and why they go blind.

Chronically elevated glucose leads to chronically elevated levels of glycation. Glycation damages cells and tissues everywhere in the body, but firstly in the veins and arteries, which are already significantly more susceptible to damage because of the chronically elevated blood pressure. This leads to more and faster plaque formation, as well as cholesterol production for damage control and repair. Elevated glucose levels and heightened glycation lead to a flood of free radicals and vastly increased systemic inflammation, which makes everything worse, much worse.

And all of these conditions, all stemming from insulin resistance and chronically elevated blood sugar, give rise to the multiplicity of the health problems just enumerated that are the main causes of death in the general population, but which are seen with an approximate three to four fold increase (that’s 300-400% more!) in incidence for a given age in the diabetic population.

What about non-diabetics? Do they need to be concerned about this? Does it mean that there is a direct relationship between blood sugar and blood pressure in all of us? Does it mean that all of us suffer from the whole lot of direct and indirect consequences of having high blood glucose concentrations in the same way as diabetics do, but in proportion to the concentration and the time it takes for it to drop depending on insulin sensitivity? What do you think?

Is any of this surprising? Not in the least: it makes perfect sense. Is it difficult to understand why it happens? Not really: when we understand some basic physiology and biochemistry, everything becomes relatively easy to grasp and explain. At least that’s what I hope I was able to show here, and at the very least, in regards to the question posed in the title that we set out to answer in the first place. You got it, right? And you’ll remember? And next time you see your MD, (if you have one, that is), ask them why diabetics have high blood pressure, and see what they say…

If you enjoyed reading this article, please click “Like” and share it on your social networks. This is the only way I can know you appreciated it.

Such a simple and yet powerful natural anti-inflammatory

He knocks at the door, walks in to my office, and, barely capable of holding back his excitement and enthusiasm, says: “It’s amazing! The pain is completely gone! It’s just been six days since I started, and the pain is gone! I can’t believe it! It’s like a miracle!” I was very happy for him. “I’m glad to hear that”, I said, “and although it may seem like a miracle to you, it makes perfect sense to me. In fact, I would have been surprised if it hadn’t worked.”

About a month before that, we crossed paths in the bathroom. He was wearing a plastic and neoprene brace on one of his wrists. I had never seen him wearing it, and so I asked what had happened. He told me that about three years ago, he had injured his wrist and that it had never healed properly. Sometimes it hurt more, sometime less, but that it had been particularly uncomfortable for about a week, especially typing at the computer most of the day. He said physicians had prescribed anti-inflammatories of various kinds, and at different times, but none had helped in allowing the wrist to heal or making the uncomfortable pain and stiffness go away.

We hadn’t really talked much before that, him and I, and he said, rather jokingly: “Do you know what to do to help it heal?” To his surprise, I think, I said: “Of course I do!”, and then laughed, partly because it was a little funny to say that, but also to break the ice between us. This is what I then went on to say:

“Chronic pain like that, especially in or near a joint, is usually caused by the an excess of uric acid stored in the tissues. Uric acid is the primary metabolic waste excreted in the urine by the kidneys. Since most of us are deeply and chronically dehydrated, the blood becomes saturated with acid that cannot be eliminated in the urine because of the lack of water (and/or salt). But since blood pH cannot be allowed to drop, the acid is pulled out of the blood and stored in the tissues. Over time, all the tissues of the body become acidic. This makes us more susceptible to ailments and injuries of all kinds, and when something happens to cause damage to a soft tissue, like a sprain, for example, the injury does not heal, or takes an excessively long time to do so.”

“What do I need to do?”, he asked. “Do you drink water?”, “Very little: I have a small glass once in a while, with lunch, for example, but I hardly ever drink water, really.” “Well, you have a big part of your answer right here. You absolutely need to drink water. Otherwise, the kidneys cannot eliminate metabolic acids.”, I said.

“From now on, this is what you will do, every day: When you get up in the morning, drink half a litre of plain water. Thirty minutes before lunch, drink half a litre; and thirty minutes before supper, drink half a litre. That makes a total of one and a half litres of water, always on an empty stomach to ensure maximum hydration, and always about thirty minutes before meals to ensure good digestion.”

“Now, in addition to that, which is really the strict minimum amount of water anyone should drink, you will have to, and this is very important, drink one liter of water with the juice of two lemons, a teaspoon of unrefined sea salt, and a little bit of stevia to sweeten. You will do this either late morning, at least an hour before lunch, or late afternoon, at least one hour before supper. It is very important that you drink this lemon water on a completely empty stomach and wait about an hour before eating anything.”

“Doing this will hydrate the digestive system, the blood and the tissues; the lemon water with salt on an empty stomach will, in addition, alkalise the blood, and thus allow the tissues to release the stored acid back into the bloodstream; and these together will allow the kidneys to eliminate this accumulation of metabolic acid each time you pee. In a relatively short amount of time, your wrist will feel better, but everything else in the body will function a lot better as well. Inflammation is not localised; it is systemic. And to get rid of it, we need to get rid of it everywhere.”

“OK. I’ll do it.”, he said, “This is more water than I have ever drank in my life, and I don’t know if I’ll be able to actually drink that much, but I’ll try, and I’ll let you know.” One month later, exactly one week after he did start to drink more water and the lemon water with salt, the chronic pain he had in the wrist, the chronic pain he had had for about three years after the initial injury, the chronic pain for which he had been prescribed and taken a variety of different anti-inflammatory medications, and none of which had worked to help heal the injury, the chronic and long-standing pain was gone. It was completely gone, and it felt like a miracle to him; we can understand why.

I start every day with half a litre of plain water, at least. I usually drink a total of about one litre over the course of about 2 hours. About 1.5 hours later, around 10:00, I make myself a lemonade with one lemon, half a teaspoon of salt and a little stevia in a little more than half a litre (about 650 ml) of water. I drink it relatively quickly and then always rinse the mouth well with plain water in order to avoid any issue relating to the mild citric acid damaging the enamel of the teeth.

Then, I slowly drink my daily green juice over the course of about one hour. Around 12:00 I have another half litre of water, plain or with chlorella or evaporated green juice powder, salt and stevia. I eat around 14:00. For lunch I usually have my coconut milk pudding, but sometimes have a big green salad with some grilled fish at the canteen (once or twice a week).

After lunch, I wait at least two and usually three hours before drinking again, depending on what I ate, (high protein or not). I will usually have a good three quarters of a litre of plain water around 17:00. Then, around 18:00-18:30, I will prepare myself another lemonade with the juice of one lemon, half a teaspoon of unrefined salt and some stevia in a little over half a litre of water. I rinse the mouth with plain water, and usually leave work to ride back home on the bike. When I get there, I drink half a litre of plain water. We have supper about 30-45 minutes later. I usually don’t drink anything more after supper, except for a small glass before bed sometimes.

That’s it: lots of water, lots of salt, lots of lemon water, lots of green juices. A wonderfully simple, effective and powerful natural anti-inflammatory combination for you, your parents, your children, and everyone everywhere. I’ll be happy to hear from you if you want to share a personal story or experience that relates to this.

If you enjoyed reading this article, please click “Like” and share it on your social networks. This is the only way I can know you appreciated it.

On the origin of cancer cells – part 1

On February 24 1956 was published in the journal Science a remarkable and exceptional paper by an equally remarkable and exceptional scientist. The paper was entitled On the Origin of Cancer Cells, and the author was the winner of the 1931 Nobel prize for Physiology or Medicine, Professor Otto Warburg.

otto-warburg-old-highresfaceshot

Professor Otto Heinrich Warburg (1883-1970)

After more than 50 years of research on cellular respiration, metabolism and physiology, Warburg had identified, understood, demonstrated and now explained the mechanisms by which cancer cells develop, survive, spread and proliferate, and what, at the most fundamental level, distinguishes them from normal cells.

It is my intention to relate the essence of these results, together with the necessary background, as clearly as it is possible for me to do with the hope that you will remember it well. This is without any doubt one of the most important and far-reaching results of medical science in its entirety. Such is the importance of this work, that it may well be the most important bit of medical science I will ever write about and that you will ever read about. But although this is so, it can be stated in a single sentence.

The truth about the origin of cancer is that despite the numerous carcinogenic agents, those identified as such and those still unknown, and despite the numberless forms and tissues in which cancer can manifest itself, there is only one fundamental cause of cancer at the cellular level: injury to respiration by damage to mitochondria.

Biological energy

The mitochondria, independent micro-organisms with their own metabolic and reproductive systems living symbiotically with the other organelles inside the cell, could be considered as the most important of the organelles because it is the mitochondria that normally produce the energy (in the form of adenosine triphosphate or ATP) on which each cell, and therefore also the entire organism, rely for function and survival.

Each cell must produce the energy it needs to sustain its activity and maintain its structure, and each cell cares only about itself: it knows only what it must do and what it needs in order to keep itself alive in the best possible condition and health that it can manage through continual adaptation. The way it knows anything else outside of itself is by sensing its environment, its immediate surroundings, through the various sensors (biochemical receptors) and doorways (ionic channels) in its walls (the cell’s outer double-layered membrane).

Cells can produce energy using glucose (from carbohydrates), amino acids (from protein) or fatty acids (from fat). By far the most effective way to do it is through burning fatty acids. This produces the most energy and no acidic byproducts. This is therefore a normal cell’s preferred fuel.

There are two intervening factors, however, that make it rather rare for humans to function primarily on energy derived from fat. And although this is true today, it wasn’t for the bulk of our evolutionary history during which all species of homo must have derived most, and probably often even all, of their energy from fat. The first and most important of these factors is that today, we tend to get most of our calories from carbohydrates.

Because it is easier for cells to breakdown and use the much smaller and simpler glucose molecules than it is to use the longer and more complex fatty acids, while there is enough glucose in the bloodstream, it will always be used preferentially, and eventually almost exclusively, as the cells grow insulin-resistant and become unable to use fatty acids almost completely. In such a metabolic state, because protein can relatively easily be converted into glucose, this is what the body does when it runs out of glucose, because, from the lack of practice, it cannot access the fat stores. Therefore, due to insulin resistance, fat just keeps accumulating, stock piled in ever larger and distended fat cells throughout the body, and never used to make energy for the now struggling, energy-starved cells.

The second factor is strictly physiological, and relates to the fact that it takes longer to oxidise fat than to oxidise glucose, and even for glucose, it takes about 100 times longer to oxidise inside the mitochondria than it does to process it anaerobically (without oxygen) in the protoplasm, the general space within the cell, outside the mitochondria. For this reason, in circumstances where the cell needs ATP quickly (in lifting weights or sprinting, for example), it will need to use this super fast energy production mechanism in addition to the slower oxidation in the mitochondria, with proportions that depends on the energy demand.

All ATP production using glucose begins with its breakdown into something called pyruvate. This is called glycolysis (or substrate level phosphorylation). It takes place whether there is oxygen available or not, and does not involve the mitochondria because it takes place in the protoplasm. Glycolysis involves 10 steps each of which requires the action of specialised worker proteins (respiratory enzymes). From this process the cell derives two molecules of ATP. Pyruvate is the main product, but the process also leads to the production of lactic acid and hydrogen ions.

At this point, the pyruvate can be carried to the mitochondria where through a much lengthier and vastly different process (oxidative phosphorylation), which in this case relies on an ample supply of oxygen, the mitochondria can produce up to an additional 34 ATP molecules (this is the case in aerobic yeasts), for a total of 36 counting the first two from glycolysis.

In practice, factoring in some metabolic inefficiencies in the process, the result is probably somewhere around 28-30 molecules of ATP for our cells. This is nonetheless a lot of energy—15 times more than from glycolysis alone—that can be derived from a single molecule of glucose. Bear in mind, however, that gram for gram, fat can produce six times more energy than glucose, raising the total to around 200 molecules of ATP, and this without producing acidic byproducts.

Aside on the use of words and names as symbols

Before going any further, I want to bring your attention to something important, generally unrecognised, but essential to our understanding and perception of the world and everything we come into contact with. It is language, complex language, symbolic language, that allowed a small subgroup of Homo Sapiens to first distinguish themselves from all other animals and also from all other species of Homo, and then spread across the continents and come to dominate almost every ecosystem on the planet.

The more language is refined and the more thorough is its mastery, the more complex cognitive processes become and the more subtleties of understanding can be both expressed and discerned. There is a major problem, however, that comes about in every language-using person, and this is that the symbol used to refer to something, the word, is unconsciously taken to be the same as the object to which it refers. Furthermore, not only is the object treated as an entity on its own, a thing that does not depend on anything else to be what it is (which, of course, it does), but the word also becomes a thing unrelated to other words that are different in appearance and sound.

This is a serious problem for understanding complex processes. And it is particularly relevant in this discussion here. We must remember that even if we are talking about all sorts of different things like glucose, amino acids, fats, pyruvate, enzymes, mitochondria, organelles, and on and on, that these are all words, symbols that we use to identify molecules and little beings like mitochondria that do not possess language, and further, that do not care at all what we call them.

It is best to view this whole business of processes at the cellular level as a ceaseless dance where atoms mostly of carbon, hydrogen, oxygen and nitrogen with a few others here and there, combine into molecules that are manipulated by proteins into other molecules, sometimes simpler and sometimes more complex, the change sometimes being unidirectional and sometimes a reversible state change going back and forth, everything depending everywhere on the characteristics of the environment, the stage, in which this dance is taking place. And that all of this takes place totally unaffected and independently from any of the names we have for any of its characters and dancers.

So don’t be fooled by the words and names in thinking that because the names are so different they are referring to inherently different things. This is not so. Words and names are just words and names. We use them to express ourselves, but must not be moved to believe that they are referring to entities having a life of their own, interacting in a world of things where every thing bounces against every other thing. This is just wrong, and it is highly misleading: clearly misleading in the realm of cellular biology, which is our immediate concern in this article, but also misleading in our everyday, which should definitely be of concern.

Back to cellular respiration

Cellular respiration (oxidation in the mitochondria) requires oxygen. If for any reason there is not enough, the cell uses a backup method to sustain its energy needs. This happens when the energy demand is so great that the cell cannot wait for the mitochondria to produce the additional ATP (as mentioned above under extreme exertion), but also if there is simply a lack of oxygen for any other reason, whether it is acute, like from exposure to a large enough amount of a respiratory (mitochondrial) poison or during an asthma attack, or chronic, like when we spend our days in an office building with recycled air where levels of oxygen are lower and carbon dioxide higher than they should ideally be, but not quite enough to become a problem noticeable by a critical number of people. In such cases, instead of being brought to the mitochondria, the pyruvate can be used as the oxidative agent by the respiratory enzymes to ferment the lactic acid, and recondition the NAD so that it can engage again in the breakdown of another molecule of glucose into pyruvate. (We’ll come back to the details of this another time.)

Essential to remember is that for a normal cell this is the solution of last resort when there is not enough oxygen, and that animal tissues suffer serious damage when deprived of oxygen for an extended time, where ‘extended’ here is on the timescale of cellular processes, which for us is very short—on the order of minutes.

Anyone who has done all out sprints with high resistance on a bike, or bench pressed a heavy weight to muscular failure, knows the feeling associated with the muscles being unable to respond to the load. This is because the cells are starved of oxygen and overloaded with acid. Under extreme exertion, lactic acid fermentation for ATP production dominates from about 10 to 30 seconds, and muscular failure follows within 30 to 60 seconds.

Struggling to survive

As we’ve seen, there are two major differences between these processes of using glucose for energy production. The first is that for one molecule of glucose, complete oxidation produces around thirty molecules of ATP, whereas glycolysis or fermentation produces only two. The second is that oxidation occurs inside the mitochondria, whereas fermentation, sustained by respiration enzymes, takes place outside the mitochondria. Therefore, it is both the quantity and quality of the energy that is degraded.

Also as we’ve seen, a normal cell under normal circumstances sustains itself—both in function and structure—by relying on the energy produced by the mitochondria, whether by oxidation of glucose (pyruvate) or fatty acids, and only ever use fermentation for energy balance adjustments in exceptional circumstances. If, however, for any reason at all, even a small number of the mitochondria in the cell get damaged, a serious problem arises because the injury makes the cell incapable of producing the energy it needs for proper function, maintenance and repair.

If the damage is severe, the cell will die, and will, if things are running relatively smoothly, be broken down, cleaned up, excreted and replaced by a new one that will take its place. If the damage to the mitochondria is not so severe, the cell will not die, but will be crippled in its energy-producing capacity, the mitochondria will not be able to produce all of the ATP the cell needs, and this will force it to use fermentation to top up its energy requirements.

Unfortunately, the injury to the mitochondria’s genetic code will not only be passed down from the damaged parent to the next generation, but will lead to an irreversible degradation of mitochondrial function with each transcription and reproduction into each successive generation of these vital organelles. With each generation, the mitochondrial function is degraded further and the energy deficit grows.

As a consequence, the growing energy deficit is compensated by increasing ATP production from fermentation. But the energy from fermentation is not just less plentiful, it is also of a much lesser quality compared to that resulting from proper aerobic respiration involving the mitochondria, and it simply cannot maintain the structure and function of the cell. Thus, the cell degrades. Everything about the cell degrades as it struggles for survival.

The evolution in the ratio of energy produced by respiration to that produced by fermentation, initiated by the damage to the mitochondria and driven by the cell’s striving to maintain energy balance, is in fact a devolution from a finely tuned energy production system of a highly refined and specialised cellular structure and function, to a primitive energy producing mechanism and a coarse and severely degraded cellular structure and function akin to what we see in yeasts and fungi.

The birth of a cancer cell

Degradation and devolution continue until fermentation energy is enough to fully compensate the loss of respiration. It is at this point that we witness the emergence of a cancer cell. And it is now a perfectly functional and healthy cancer cell that has lost enough of its original characteristics, both structural and functional, to begin a programme of its own, intended to increase as much as possible survival probability in its new and partially self-generated environment that should ideally be high in glucose—as high as possible, low in oxygen—this is preferred but not critical, and highly acidic—cellular pH as low as 6 or even less and extracellular pH potentially significantly lower.

Although these terms, birth and emergence, are powerful and very useful in conveying a vivid imagery of a developing process that eventually reaches and overcomes a critical threshold as it is the case here, it is not really a birth or an emergence as much as it is a metamorphosis, gradual and typically very slow, taking place over decades if not over most of a person’s lifetime, with a continual and intimate dependence on the biochemical makeup of the environment surrounding the cell, and surrounding each and every cell throughout the body, from hair, scalp and skin, to fingers, fingernails, toes and toenails, from mouth to colon, from brain to liver, from breast to uterus, from throat to prostate, and from and to everything else that constitutes the entire human organism inside and out.

Over this long struggle for survival, because this is truly what it is, the cell is at first forced to generate supplemental energy from fermentation to make up the small difference that the slightly damaged mitochondria cannot. This increases the level of acid inside the cell. Because every enzyme-mediated biochemical process that takes place—and that indeed has to take place—is sensitively pH-dependent, all are instantaneously affected negatively by this acidification and drop in pH.

Moreover, increased acid translates directly into lack of oxygen, which further stresses the mitochondria, making their oxidation of glucose and fatty acids more difficult and less efficient. This in turn leads to a further degradation of the mitochondria, cell structure and function, an increased reliance on fermentation energy, a rise in acid levels, and a drop in oxygen availability: clearly a vicious cycle—a very vicious cycle.

Because ATP production is so much less efficient through fermentation than through respiration, the cell needs much greater amounts of glucose. This forces it to develop a greater sensitivity to it, which forces the formation of more insulin receptors because it is insulin that carries the glucose through the cell wall. And it is, in fact, the case that cancer cells typically have about ten time more insulin receptors than normal cells, and that this makes them ten times more capable of grabbing hold of circulating glucose to sustain themselves. But again, remember that this is yet another adaptation in a struggle for survival without which the cell would die.

Questions, questions and more questions

There is quite a lot more that needs to be addressed and explained. General questions like: How did Warburg figure all this stuff out? And what else did he discover? Specific questions like: Are cancer cells weaker or stronger, more fragile or more resilient? What is it that fundamentally distinguishes them from normal cells? And why does it sometimes take an entire lifetime but at other times just a few years to grow a cancerous tumour? Epidemiological questions like: Why is cancer spreading? Why does it appear more and more in young people? And why does it tend to not only develop but intensify with each generation along family lines? Finally, from all of this detailed information and knowledge, wouldn’t we like to know if there is something to do to prevent or cure cancer? Wouldn’t we like to know what that is: what we can do to prevent and cure it? Of course! That’s our main goal, isn’t it?

We will look at all of these issues and more together, but now I can’t help wonder if the following question, this multi-billion dollar question, might have popped up in your mind while you were reading, as it did for me when I read Warburg’s paper: If he, and by extension, we, as the community of thinking human beings, had understood, explained and demonstrated how cancer arises and then develops in 1956 already, why is it that today, almost 60 years later, cancer rates continue to rise every year, cancer cases appear in people at an increasingly younger age every year, and cancer claims the lives of more people every year than it has ever done? How can this be, and why is it so? Hasn’t anybody else looked at his research and reproduced the results? Haven’t we got today much better instruments and technical means of verifying everything he presented throughout his long career? Don’t worry. We’ll definitely look at that too.

If you think this article could be useful to others, please ‘Like’ and ‘Share’ it.

The crux of intermittent fasting

It is less than futile, in fact, it is outright nonsensical, to argue in favour of or promote an explanation that is in contradiction with observational evidence. What is required is to find, or at least try to find, a sound and well-founded explanation. And not just for some of the observations, but for each individual observation, as well as for the entire ensemble of observations. This is what we should do.

Fasting means not eating; everyone knows that. The meaning of the word has been loosened to include not consuming appreciable amounts of calories, as in doing a green juice fast, for example, but which should instead rightly be called a cleanse. The expression intermittent fasting implies a cycle of some kind, and is used to mean not eating for periods of 16, 18, 24 or 48 hours, but on a regular basis, like every week or even every day.

Fasting has been known and recognised for its often quasi-miraculous curative effects for thousands of years. Indeed, it is possible to find accounts of individuals recovering from just about any ailment and disease imaginable simply from fasting long enough. It seems, however, that fasting as a healing modality, has, over the past couple of centuries, steadily grown less popular in the medical profession and, as a consequence, also in the general population.

A resurgence of scientific interest over the last decades in the benefits of fasting for treating various degenerative conditions like arthritis and cancer, but also for extending healthy lifespan about which I will write at one point in the future, has brought it back into the spotlight, especially in circles of optimal health enthusiasts, which includes some gym go-ers and body builders interested not so much in optimal health, but mostly in losing fat and gaining muscle.

Therefore, there has been quite a few people trying out or adopting intermittent fasting for periods of a few weeks to a few months, or even longer, but reading things here and there shows that they have had varying success given their initial motivations, whatever those might have been.

Ori Hofmekler was one of the first to popularise the idea of intermittent fasting with his book The Warrior Diet. He has continued to write and to encourage intermittent fasting for a wide range of benefits, especially in regards to the goal of improving body composition, as one of his last titles expresses perfectly: Maximum Muscle, Minimum Fat.

Dr Hertoghe, the world famous endocrinologist and anti-ageing specialist, as well as Mark Sisson (Primal Blueprint) have also been vocal and influential proponents of intermittent fasting for a while. More recently, Dr Mercola did several interviews with Hofmekler, and wrote a few articles on the topic, sharing his experience and enthusiasm for the health and fitness benefits intermittent fasting can bring. These are just some of the well known players that I know of and respect in the natural health community, that have endorsed and promoted this kind of cyclical fasting.

Naturally, as is the case for almost any topic we can think of, there are opposing opinions and, in fact, bashing of intermittent fasting as a means to improve health and body composition, especially in the popular fitness and gym culture. And, as is also the case for almost any topic we can think of, contradictory views and opinions are usually caused by misunderstanding, or at least, incomplete understanding of the elements involved, and in particular the more subtle ones.

On the one hand, we have the proponents claiming that we can very effectively get much healthier, with much improved energy levels, mood, digestion, and natural detoxification and excretion of metabolic acids; normalise and recover the optimal balance of specific hormones, and eventually, of the entire hormonal system; over time lose all excess body fat reserve, increase flexibility and hasten recovery, better preserve our precious muscle tissue and build more very efficiently. And these are just some of the claimed (but also documented) benefits of intermittent fasting.

On the other hand, the nay-sayers and bashers report that these claims are more than just false, they are, in fact, often the exact opposite of what they have found or seen for themselves or in others coming to them for help and expert advice. Reports of feeling really terrible, with massive headaches, bad digestion, awfully low energy levels, and thus, obviously, very bad and destructive moods; loss of some fat but also, over time, of lots or maybe even most of their muscle tissue; extreme hunger, with frightening ravenousness when evening mealtime comes around, leading to monstrous, uncontrolled and uncontrollable overeating without discrimination of food kinds or quality, and over time, showing obvious signs that can be identified as those associated with eating disorders.

How is it possible to have research, studies and documented cases—plenty of documented cases—that provide observational evidence—proof, if you prefer—that support the claims of both of these camps? How can we observe and actually measure such profoundly different consequences in different people that are supposed to follow comparable diets, consequences that are diametrically opposed to one another. In other words, observational evidence that appears to be completely and totally contradictory?

A simple approach, the one espoused by many, maybe most, of the intermittent fasting bashers, is to just say that proponents are wrong and imagining things, letting themselves be fooled by the hype, but actually blind to the reality of the detrimental consequences of practicing cyclical fasting.

For me, the only satisfactory approach is the one that seeks to explain all the observations, to reconcile all the observational evidence, and make sense of the entire ensemble of information available through a physiology and biochemistry based explanation that is complete. I also think it is fair to say that there are more better informed proponents than there are opponents, but this is not obviously the case, and I would thus not bet much on this claim.

Here it is, the crux of the matter, the one single crucial element needed to understand and explain the wide spectrum of apparently contradictory observations that is overlooked because it is misunderstood:

The body’s response to intermittent fasting is entirely dependent upon the state of one’s metabolism, and everything about it hinges on the physiology of nutritional ketosis. 

In fact, the vast majority of the benefits of intermittent fasting are those derived from nutritional ketosis but heightened by the fasted state, and therefore, can only become manifest if the fasting individual is keto-adapted and remains in nutritional ketosis most of the time.

You might be thinking: what in the world is nutritional ketosis, and where’s the explanation for the contradictory observations? Nutritional ketosis is the metabolic state in which the liver manufactures ketone bodies from fat to provide fuel for the brain cells that can only use glucose or ketones for their energy needs. This only happens if and when circulating insulin levels are low, and when blood glucose stays below 80-90 mg/dL for a period of 24-48 hours (generally speaking, on average, and in normal circumstance). The reason is fat will not be burned for fuel is there is plenty of glucose in the blood, and in order to burn fat, insulin must be low.

This metabolic state is induced either by fasting—this is the quickest but also most extreme way to do it, or by eliminating insulin-stimulating carbohydrates (sugars and starches) from the diet—this is by far the easier and obviously much more sustainable way to do it. The longer it is maintained, the better adapted the metabolism becomes. But before ketones are produced to fuel the brain, the body goes through metabolic changes to which it tries to adapt as best it can. The most important but also most severe of them all, is the fundamental shift from using glucose as the primary fuel, not just for the brain, but for all cellular energy needs in the body, to using fats, both from body fat reserves and from food.

The bane of our time is global, chronically elevated insulin levels. Hyper-insulinemia, as it is technically called, sits squarely as one of the root cause of all the diseases of civilisation that kill most (90%) of us today, more or less uniformly across the planet. What does this have to do with our considerations of intermittent fasting? It has everything to do with it:

Insulin is the master hormone that orchestrates the metabolism in what relates to storage and usage of macronutrient (carbs, fats, and proteins) at the cellular level.

Chronically elevated insulin always and inevitably leads to insulin resistance. Insulin resistance means that cells do not respond to insulin as they should, and require ever increasing concentrations of insulin in order to move glucose into the cell. And ever increasing concentrations of insulin means ever increasing inability to use fat cellular fuel, with particular difficulty in unlocking and tapping into the usually greatly overabundant reserves of body fat.

What is truly remarkable is that insulin resistance, even if it has been developing and growing steadily with each passing day and with each high carb meal or snack over our entire lifetime, it can be reversed in weeks when insulin-stimulating carbs are eliminated from the diet: 48 hours to enter nutritional ketosis; one week for water retention release, initial intestinal detox and basic adaptation to fat-burning; four weeks for functional keto-adaptation; and 8 weeks for complete keto-adaptation.

Eliminating insulin-stimulating carbs eliminated the need for large insulin secretions by the pancreas. Therefore, both glucose and insulin concentrations steadily decrease with time, and eventually fat-burning and ketone production kicks in, marking the first step in the transition of the metabolism from sugar-burning to fat-burning, which is what we referred to as fat- or keto-adaptation.

There is a catch though: before fat-burning and ketone production begins, the metabolism of the insulin resistant individual will go through withdrawal from its sugar addiction. First, sugar levels start to drop. After a number of hours, 3 to 4 hours say, blood sugar is too low to supply enough fast-burning glucose to cells for their metabolic activities. Because insulin remains high, and because the body is highly insulin resistant, as we said, it is not possible to use fat from the body’s fat stores. Therefore, it is the liver that comes to the rescue and begins to convert its stores of glycogen into glucose and pumping that into the bloodstream to provide cellular fuel.

Within a few hours, however, the glycogen in the liver is depleted, and blood sugar drops once again, and lower still. Because the body remains unable to tap into its fat reserves due to the state of insulin resistance, it has, at this point, no choice but to turn to muscle tissue, from which it is far easier to breakdown protein and manufacture glucose than it is to start burning fat. And thus, the muscles are eaten away in order to provide the glucose to all of the multitude of insulin resistant (sugar-addicted) cells throughout the organism.

We now come to the final analysis of our observational evidence in regards to intermittent fasting, and consider two scenarios that can explain, as it rightly should, the ensemble of observations in its entirety, and thus clarify and reconcile the apparent contradictions that are seen, and which lead to serious confusion about the issue, even, and maybe especially, among our health, fitness and bodybuilding experts.

Scenario 1: We take a perfectly keto-adapted person who has been eating a diet devoid of insulin-stimulating carbs for a long time, and who therefore always has very low glucose and insulin levels, and as a consequence, exquisite insulin-sensitivity. What happens if they stop eating? Nothing special, really. Their body is always using fat and ketones to supply all healthy body and brain cells with their metabolic energy needs. So, if there is no fat that is provided through the digestive system, then it is taken, without any trouble or noticeable changes in energy levels or concentration, from the body’s fat reserves that are always plentiful, even in the leanest among us with single digit body fat, because 1 gram provides 9 calories, which means that we need only about 200 g for a whole day of normal activities, and have at least 5 kg at any given time (8.5% fat on 60 kg body weight).

Moreover, if we exercise during the fast, there is no noticeable difference because at low intensity, cellular energy needs are taken care of by fat which is continuously released from the fat stores into the bloodstream, while at higher intensity the glycogen stored in the muscle cells themselves, can be used in the form of quick burning glucose together with additional supply from the liver than converts its stores of glycogen if need be (if stress hormones are secreted).

So, biking and working out with weights, for example, is perfectly fine and actually feels great. Even more interesting is the fact that stimulating the muscular system by exercising while fasting triggers the release of various hormones in addition to growth hormone for which there is nothing more effective than fasting, whose purpose is primarily to preserve those physiologically important muscle tissues as essential for functional survival, while breaking down to recycle the proteins of other tissues which are not required like lumps, tumours, and scar tissue. And this means that the hormonal environment created by exercise under fasting conditions is conducive to both preserving and building more muscle, all the while also expediting and maximising fat-burning. And this is what is observed.

Hunger is present at times, but is certainly far from being problematic. There are no headaches, no stomach pains, no sleepiness, no scattered mental discursiveness, no problems concentrating or working. Sitting down to eat the evening’s nutrient-dense, enzyme-rich and high fat meal with adequate amounts of protein for tissue repair and muscle building, is nourishing, perfectly satisfying, and well digested throughout the evening and night, as long as we eat several hours before going to bed. No over-eating, no cravings, no psychological disturbances, no problems at all. A picture of perfect metabolic efficiency.

Scenario 2: We take an average but pretty active person from the general population who eats a standard diet with plenty of insulin-stimulating carbs, both simple sugars, and complex carbs in the form of pasta, rice, whole grain bread, etc (70% of calories), and who therefore always has high blood glucose and insulin levels, and as a consequence, pretty strong insulin resistance. What happens if they stop eating? We saw this earlier: blood glucose drops, but not insulin; the liver starts to pump out glucose to pick up the slack, and runs out after about 3-5 hours; sugar drops once more, but not really the insulin; since fat stores cannot be tapped into, muscle tissue is broken down to manufacture glucose; longer period of fasting means more muscle breakdown.

If we exercise gently, things are fine at first because we can tap into the glycogen stored in the muscles, but will soon get much worse because we increase the energy demands, but continue to be unable to use body fat stores, and therefore increase the rate at which muscle tissue is broken down, especially if we do weights and high intensity training.

Low intensity aerobic exercise depletes glycogen from the muscles and when it runs out, we feel exhausted, completely flat out. (This is the same as hitting “the wall” in long distance events, and only occurs because the body cannot readily tap into its fat reserves: a well keto-adapted athlete never really hits any such walls!) Far worse is high intensity exercise, which causes more intense and faster muscle breakdown, the higher the intensity, the more muscle breakdown.

Waking up in the morning after a night’s sleep (and unconscious fast), we are starving, dearly longing for the bread, the jams, the cereals, the orange juice, the waffles, the maple syrup, and everything else we can imagine, but we hold out and go to work. Every hour is excruciating, terrible headache, hunger pains throughout the abdominal cavity, but when these subside, we are falling asleep, with a complete inability to concentrate on anything at all. We feel like shit.

By the time evening rolls around, we are so ravenous we would eat a horse. So we sit down and eat, and eat, and eat everything we can get our hands on: pizza, pasta with sauce and cheese, garlic bread with butter, steak and potatoes or french fries, and then desert, sweets, oh man, we waited all day to eat, and now we can eat anything and everything we want, because tomorrow we’ll be starving again for the whole day. We get up in the morning, and the whole cycle starts over again.

Over time we kind of get used to it, but because we don’t understand the most essential element of the whole thing—nurturing nutritional ketosis—we remain just as insulin-resistant, every day we feel shitty, every night we eat like a pig, and throughout the whole time, more or less, we break down muscle, and our insulin resistance prevents appreciable fat loss. After doing this for a while and seeing the detrimental effects of this regime, we go seek help from a fitness expert. They tell us that this intermittent fasting thing is a load of shit, and as them, grow instantly convinced that all the stuff people say about the benefits it can bring for optimal health and improved body composition is also a load of shit: if it didn’t work for me, then it simply cannot work for anyone.

Unfortunately, neither we nor the fitness expert understands enough physiology, biochemistry, and endocrinology to be able to make sense of these conflicting and contradicting accounts, personal experiences, and observations reported in the scientific literature, and just settle into this view that it really is a load of BS, and that it might work a little, sometimes, on some people, but not on others, and no matter what, it always leads to pathological states of mind, if not full fledged eating disorders.

It is my hope, however, that you are now able to see how these very observations, as conflicting, contradictory, and certainly quite puzzling as they may seem at first, can be explained and reconciled marvellously well in light of a better understanding of the basic principles of energy metabolism, and of the remarkable but unfortunately almost universally misunderstood state of nutritional ketosis, that most medical professionals usually mistake for the pathological condition of diabetic ketoacidosis.

Finally, in closing, I have a confession to make: I have been experimenting with intermittent fasting in one form or another for many years now. I never eat anything before midday, and on most days until about 14:00, which makes it an approximately 18-hour fast from 20:00 the night before. On weekends, I fast until noon, and then go do weight training. On those days, I usually eat for the first time around 17:30, and make that my single meal of the day. On some days I eat a large lunch and dinner to increase my overall calorie and protein intake. I usually workout 3-4 times a week, and usually in the late afternoon-early evening.

I have not experienced loss of muscle since I dropped the insulin-stimulating carbs from my diet in 2007. Both muscle tone and strength is maintained very well even after long periods without resistance training. I have, however, never made a particular effort to gain muscle mass. This year, I would like to see how much muscle I can put on, and will thus put the science to the test for myself. If you are interested, don’t worry, I’ll keep you posted. If you’re not, then that’s fine too.

But if there is a single thing you must remember from what I wrote, it is this: you can only really benefit from intermittent fasting when you are keto-adapted, and remain in a state of nutritional ketosis the majority of the time. Otherwise potential benefits are lost, and the practice can become rather detrimental.

hunterslookingoverplain

How long do you think these hunters hunt each day? Do you think they have a big breakfast before going, or a large lunch while they are out? How long do you think they are out before they settle back around the fire in their village to have their main meal of the day? And what do you think they will eat when they do return with their catch of the day?

(This article was written after reading this article by Dani Shugart on T-Nation sent to me by a friend who knew I would have some remarks to make, and probably some clarifications to bring to it.)