Monday, January 9, 2017

Detoxification demystified


The end of year break is over, spring is coming soon. As per tradition, in this period there is a boom of articles in magazines, blog posts, offers from healthcare professionals and obviously products... about detoxification. I am a convinced follower of traditions, so why shouldn't I write something about it, too? Especially since there is so much to say.

Warning: despite the carelessness with which many people speak about the subject (not to mention the para-scientific solutions proposed) detoxification is a science. As such it has its own language and includes many difficult concepts. In this post I'll try to do my very best to convey the facts in the most simple and accessible way, all by staying scientifically correct.

Let's start as usual, by defining the problem: if we don't have a good understanding of the causes we can't evaluate the validity of a solution.

What is detoxification


Toxins and detoxification

I already spoke abundantly about toxins in a previous post. However toxins must not be intended exclusively as poisonous substances we introduce in our bodies, but also the end-product of the metabolism of other molecules that are not perforce unhealthy. I'll come back to this point later.

Detoxification is a series of processes that metabolize and eliminate toxins, drugs, hormones, dead cells and even nutrients. Detoxification occurs contiuously, just to make a simple example: adrenaline (the hormone of fear). Its action is immediate however, if the stimulus that triggered its secrection ceases, its effects last just some minutes. The half-life of adrenaline in the human body is about 2 minutes (every 2 minutes the amount of adrenaline in our blood is halved). What is happening is that our body is detoxifying it: the adrenaline is metabolized into inactive by-products and the same are eliminated through the urines. If this mechanism didn't exist, once we have been scared once we would stay scared for life.

The same happens with countless chemicals, both organic and inorganic, for example:
  • alcohol (if we didn't metabolize alcohol we would stay drunk forever)
  • caffeine (we would stay awaken for ever)
  • toxins in the food (both natural and artificial), in the air we breath or the water we drink
  • even the toxins we absorb through our skin (creams, soaps, shampoos, hand-sanitizers, ...)
  • metals (lead, aluminium, mercury, ...)
  • medicaments
This wonderful system is what allows us to survive. When the body cannot metabolize a substance, this represents a poison for us (think about deadly mushrooms).

Our body also has a limited capacity to metabolize other substances, hence the saying "the dose makes the poison":
  • drink one coffee and you'll be fine
  • drink the equivament in caffeine of 50 espressos in one go, and you're dead

Detoxification Protocols

A detoxification protocol is a series of actions taken with the intent to facilitate the naturally occurring detoxification processes.

Although in an ideal world one should not need to regularly undertake this kind of exercise, we live in a progressively more and more imperfect world, so yes: our detoxification processes need support.

It is not a coincidence that every traditional culture and religion included what effectively is a recurrent detoxification protocol, often paired with spiritual practices to underline the importance of purifying the soul together with the body (hint: detoxification is a parasympathetic process and, as such, it works better if you manage stress properly).

If our ancestors felt the need for detoxification practices, why shouldn't WE need them, since we are living in a period of unprecedented toxins exposure?

Let's start digging more into the details of detoxification, starting from...

The lymphatic system

Everybody has a basic understanding of the circulatory system in the human body (blood, heart, arteries, veins and capillares). With a huge abuse of scientific talk, one can say that our bodies have a second circulatory system: the lymphatic one.

The role of the first is to bring nutrients, oxigen, hormones to the organs, help dispose the waste, and is ativated by a pump (the heart). The heart can pump around 5 liters of blood per minute.

One of the roles of the lymphatic system is to drain the extra-cellular liquids (including toxins), to collect them in the lymphonodes and there, reintroduce those liquids into the blood stream. The lymphatic system doesn't have a pump and can generally process 3 liters of liquids per day.

Poor circulation of the lymphatic system causes swelling and water retention or œdema. The lymphonodes is "where the magic happens", so the goal is to help the liquids travel towards them. This can be done in several ways:
  • exercise being the first: move, jump, walk, practice inversions... the movement of lymph is propelled by the action of nearby skeletal muscles, the movement of the lungs and the contraction of smooth muscle fibres
  • dry brush massage: remember that the movement is always from the extremities to the core
  • lympho-drainage massages
Many detox solutions propose soaking your feet in warm water with either some special salts or some electrodes. Others propose detox patches to be applied again under the soles of the feet. These methods are becoming quite popular in alternative health circles due to the fascination our feet elicit on our hunger for natural remedies (you know... feet, contact with the ground, rooting, mother earth, network of living-beings, healing energies, etc...).

The claim is that the salty water (or the special patch) pull toxins from your body, the proof is that they become brown. However, considering that the natural flow of lymphatic fluids is from the extremities to the core, this claim is very corageous (my politically correct way to say quackery). There are several causes that explain the browning of the detoxifying support, none of them are actually associated with the action of pulling toxins through the skin.

If a pediluvium helps you feel relaxed and gives you pleasure, feel absolutely free to do it. Don't expect to detoxify any better that you would have done with a good sweat. Sorry... you have to move!

Detoxification pathways

Ok, the toxins are in the blood, the extra-cellular toxins have been collected through the lymphonodes and those too are in circulation again. Let's detox them!

Phase I

Phase I happens in the liver, it uses enzymes (such as cytochrome P450) to break down toxins into intermediate metabolites. Some toxins, at this point, can already be eliminated from the organism, this is the case for example of caffeine, a molecule that impact enormously Phase I detoxification.

For most toxins however, a second Phase is required. Often intermediate metabolites are even more toxic than the original molecule.

Phase II

There are six different pathways within Phase II detoxification. They are required to complete the breakdown of chemicals, hormones and toxins, thus completing the job of Phase I. They do so by binding the intermediate metabolites to specific type of proteins and molecules that "escort" them out of the body.

I won't go into the details however, the list is the following:
  • Glutathione conjugation, 
  • Sulfation
  • Peptide Conjugation
  • Glucuronidation
  • Acetylation
  • Methylation

Enzymes and nutrients: you need to be well nourished!

We need nutrients to manufacture those enzymes that are needed for detoxification. Without the proper nutrients our body won't be able to produce enzymes and molecules to bind toxins to, and we won't therefore be able to properly detoxify.

Diets low in nutrients as well as periods of intense use of nutrients (detox protocols, or long periods of stress) deplete our resources. Often those deficiencies are chronic, that's the reason why, if we decide to start a serious detoxification protocol, we need to follow a properly individualised plan: just like overeating slows down detoxification, ingestion of proper macro and micro nutrients play an important role in our body's ability to detoxify.

Fundamental nutrients for detoxification are, for example, vitamins C and B2. Minerals like magnesium, molybdenum and manganese, which are required to activate metabolic and detox enzymes. Chelation of bad minerals may dispose good minerals at the same time, hence the need for replacement.

It is important to mention that amongst the macro nutrients required for proper detoxification, we also find amino-acids and hence proteins. Food for thought to rethink the food for detox.

Elimination pathways: how toxins leave our body

Once the toxins have been metabolised and transformed, it is necessary to eliminate them from our body.

Digestive system

Our digestive system does way more that breaking down and absorbing food. For example it:
  • scans the food for invaders
  • detoxifies poorly digested food and fermented toxins
  • filters food and intestinal bacteria
  • receives the toxins detoxified by the liver through the gallbladder
  • ... and obviously eliminates toxins and unusable substances from the body through the faeces
Being constipated is not a good starting point for a detoxification diet: if toxins and their metabolites cannot leave the body they will be reabsorbed and reput in circulation. When prioritising the issues, a healthy digestive system always takes the precedence and this includes having regular bowel movements.

I mentioned the gallbladder, such an important and yet underestimated organ: it is through the bile that the liver eliminates some of the toxins it processes. Having a congested gallbladder (often because of low-fat diets) or having a thick, viscous, poor quality bile (usually this is caused by bad fats in the diet) incapacitates the liver to eliminate them.

Bile also stimulates peristalsis, and so elimination of solid waste from the intestine. We often think that when somebody is constipated, the solution is to eat more fiber. That would be the equivalent to try to gush-out the drain pipe of the kitchen sink... by throwing-in a cup of chopped salad. Adding some healthy fats and food that supports the gallbladder may be way more efficient, this is in neat opposition to typical detox diets which recommend instead to eliminate fats...

In the endless list of detox protocols, we also find coffee enemas. My rule is that digestion is a process that works from-north-to-south, not the other way round, so I prefer not to waste time with them. The subject would even be fun if it weren't for the cases of deaths associated to it (hint: fix the causes, not the symptoms).

To resume the paragraph: it is fundamental, before attempting a detoxification diet, to make sure that the stomach, intestines, the liver and the gallbladder are working efficiently.

Kidneys

The primary role of the kidneys is to filter the blood to remove cellular wastes, such as water, bile pigments and obviously toxins that had been processed by the liver.

Kidneys have literally the ultimate task in the elimination of many toxins from the blood, it is fundamental to support them with nutrients and proper hydration.

Once again, it is non-sense and potentially harmful to initiate a detoxification diet if this main elimination pathway is not working properly.

Skin

Skin, or better the sweat glands, can be considered a second kidney, although not as efficient. Some toxins can be eliminated through perspiration and in fact many cultures acknowledged the importance of it.

A very popular mean to have a good and deep sweat going, especially in the winter period, is to regularly spend some time in a sauna or steam room. During summer the best solution is probably to exercise outdoors.

Respiratory system

Last but not least, the respiratory system.

The lungs eliminate a variety of waste products in particular, but not limited to, carbon dioxide. They also play a major role in maintaining the correct pH of the blood: I'll speak more about this in a future article about alkaline/acidic diets.

And now the big question...

What happens when any of these steps is not working? What if we can't metabolise toxins or if we can't eliminate their by-products?

Where and how toxins are stored

In an healthy and well nourished body, toxins are eliminated through the pathways mentioned above. If not, our body's first action is to remove them from circulation: poison should not circulate freely. It decides to stock them in tissues that are not very metabolically active.

Body fat

Fat tissue can store toxins such as metals, petroleum, fat soluble chemicals and other organic and inorganic compounds. Toxins can accumulate in the fat tissue for years, this is a well know issue when eating meat and fats from animals raised in non-organic ways: they are themselves toxic (exposure to toxins, hormones, anti-biotics, stress, etc).

This should also make the reader aware of the potential risks associated to weight-loss programs, especially when a lot of stubborn body-fat is lost in a short period of time. Some toxins that have stayed silent for years are now massively pulled back in circulation, maybe at a pace we cannot keep-up to.

A properly designed weight-loss diet must always take this into account: the detoxification pathways must be working and elimination open. An initial detox protocol can make a tremendous difference between a generic weight-loss diet and a healthy one.

P.S. The brain is estimated to be composed of 60-80% from fat. Fat also wraps our nerves in the form of myelin, meaning that the same toxins that are stored in body fat can be stored in our nervous system as well. An additional reason to choose wisely how to approach the problem of weight-loss...

Soft-tissues, connective tissues, lymphs, joints

This is the second favourite place for our body to store toxins. The good news is that it is also the place from where it is easier to remove them... provided one follows the correct steps.

Bones

Because of its chemical affinity with calcium, bones are the preferred stockage area for lead. Bones are the most long-lasting tissue in our body, but they are not eternal neither. A complete renewal of our skeleton takes from 7 to 10 years.

If you have a history of lead exposure, you may have to cope with it for another decade.

Detoxification diets

Please note that our metabolism is not stupid, it is not storing toxins because it is masochist, it is trying to save our lives: PCBs are better in our belly that in our blood.

As frustrating as it is, once again we cannot blame our body: the sole responsibles are ourselves who introduced toxins and didn't take care of the good functioning of our own detoxification mechanisms.

Detoxifying body tissues takes a lot of time, even years as we saw. This will immediately ring a bell and cast some doubts on some very popular miracolous 7-day detox diets.

The best that can be done in such a short periods is:
  1. to re-open the elimination pathways (first and foremost)
  2. to initiate to support the detoxification phases (Phase-II first, then Phase-I)
That said... most typical protocols of 7-day detox diets are indeed good starting points for a bigger and more in-depth detoxification program. With obvious counter-indications of course (one example for all, juice fasting is not recommended to people with blood sugar regulation issues).

P.S. You may wonder why we need to work "backwards" when reactivating the detoxification pathways (elimination, Phase-2, Phase-1). The reason is that every step requires the following to be working in order not to get stuck in the process. Now... how many detoxification specialists have you met that take this into account?

You are what you eat, literally

Sometimes toxins literally become you. I am speaking of the use of unhealthy nutrients as building blocks of your body, if this doesn't interest you I don't know what will.

Every cell of our body is enclosed by a membrane, this is self-evident. What is less evident is what that membrane of made of.


The membrane is made of a double layer of:
  • phospholipids (fatty acids containing phosphorus),
  • cholesterol,
  • glyco-lipids (fatty acids attached to carbohydrates).
Contrary to popular belief, they are not made of proteins: they are made fat, cholesterol and fat again.

Long story made short, fats are not just a source of concentrated calories like we have been brought to believe. They are fundamental structural bricks of our cells, and therefore our tissues, our organs, and finally our body. They become you.

Now, imagine your body patched with plaques of
hydrogenated palm oil and oxydized cholesterol

How long does it take to rebuild our cells?

In my opinion, the tissue that is more interesting in a detoxification protocol is the blood, since it is the "organ" that links all the other organs together.  Let's not forget that one of the roles of the blood is to deliver toxins to the liver and by-products to the kidneys, the skin and the lungs. For this reason it is also the tissue that is more susceptible to stay in contact with toxins like metals, chemicals, hydrogenated fats, drugs, and such.

Let's take red blood cells: the average lifespan of red blood cells is ninety days, this means that it takes 90 days to make a whole new set of red blood cells.

When I am asked how long a detoxification protocol should last, the unpleasant truth is that one should do it for at least three months. This is very different from the common belief according to which one can eat junk food 51 weeks per year and then detox everything with a 7-day juice fast (if only...).

It also put into a different perspective the frequency with which we should eat clean, and consequently the frequency of exceptions.

Things that may slow down detoxification


Additional toxins

It goes without saying that if one is following a detoxification protocol, the first thing to stop doing is to introduce more toxins into the body. This includes also non-food sources like smoke, chemicals, exposure to radiations and unsurprisingly: stress. Actually, wilful intake of toxins and chronic stress are better avoided all year long.

Caffeine

As mentioned before, caffeine has precedence on Phase-I detoxification. Heavy coffee drinkers may in fact be sabotaging the correct functioning of their detoxification pathways.

In the other hand, because of the fact that caffeine is metabolised only in the first phase, it may be a good ally in case Phase II needs some initial support before it can be fully engaged.

Everything is very subjective and there is not a single answer for everybody.

Nutrients that engage the detoxification phases

I was once at a table speaking with some people I just met. A man mentioned that during a trip to India he followed a detoxification program, and one of the recommendations was to avoid spices during the treatement. He joked on how weird it was to spend time in India and not be allowed to eat their tasty recipes.

I wondered why that should have been the case and immediately recalled my nutrition classes and how phytonutrients, anti-oxidants are indeed processed by our liver to be eliminated. And herbs and spices are great sources of these kind of organic compounds.

Some nutrients support detoxification, others may work against it. While not toxins themselves, they anyway provide additional job to our Phase-I, Phase-II and elimination pathways, with the potential risk to deplete the nutrients that are required for the correct functioning of this complex, yet wonderful, mechanism.

Conclusions

Thanks for reading until the end, and sorry if sometimes in this article I had to digress to complex concepts: I know why you are here, you'd like to read simple and possibly reassuring answers, like:

Alright... so that’s 2 carrots, 1 head of broccoli,
10 grapes, a couple slices of ginger, and some celery

The fact is that our bodies are complicated. I felt it was necessary to be a bit more precise to avoid writing another generic article on detoxification that wouldn't have provided much added value compared to the countless articles that are already on-line.

I hope that this post didn't discourage anybody from attempting a detoxification diet. On the contrary, my expectation is that you maturated awareness of its importance and decide to initiate one, maybe with the support of a qualified expert.

And stay tuned! More exciting stuff coming very soon!

Tuesday, January 3, 2017

The occasional exception


This is a new episode from the series of posts where I discuss the typical questions a nutritionist is asked ([1], [2], [3]). The question of today is:

But... if I eat
[unhealthy food of your choice]
only once in a while...
...it is still ok, isn't it?

I usually take a big breath and hold it in the hope to faint so I have an excuse not to reply. Unfortunately my expectations are not satisfied and find myself facing another dilemma:
  1. Say a categorical no, and be seen as a food-nazi, knowing that they will occasionally do exceptions anyway
  2. Say that, yes, it is possible to do an exception from time to time, and accept the fact that they will interpret "from-time-to-time" as an ultra-liberal:
Woah!!! He said we can!!!
Let's eat unhealthy more often
than we eat healthy!!!

Let's begin with the most obvious starting point: defining the problem.


Where does the need to cheat come from?


Diets which are low in nutrients

And for nutrients I mean anything that our bodies need to function properly.
  • Low-fat diets or diets with bad quality fats will very likely trigger an incontrollable need to binge on greasy junk-food
  • Low-carb diets will keep sending messages to our brains to eat sugary treats. I take this opportunity to remember how adrenals and the thyroid are particularly impacted by ketogenic diets.
  • Diets low in proteins. Despite everybody acknowledges the importance of this macro-nutrient, and some people even abusing of them, many don't get the required minimum amount. One tricky thing about proteins is that we will never be 100% satiated until we fulfill the needs, thus we will keep eating (often carbohydrates).
  • Diets low in vitamins and minerals. This is the case of diets that rely heavily on refined food. 
Cravings are signals from our body that something is missing in our diets, the solution is not to binge randomly, but instead to identify that our diet is deficient in. One example for all:
  • it is perfectly fine to eat more fats, as long as they are the healthy ones
  • what is not good is to stay low-fat all the week following the outdated and debunked myth that fats-will-make-you-fat-and-clog-your-arteries, just to eat industrial chips on Saturday evening because-you-live-only-once


Not eating enough

As I said several times, calorie-restriction diets cannot work on the long period. Actually the need for cheat-days show that they are not feasible even in the short period. Enough said.


Unresolved metabolic addictions to some food

This is often the case of sugar. Almost everybody knows how addictive carbohydrates are and how important it is to reduce the quantity of bad carbohydrates we eat, to replace some of them with low glycemic-load sources.

A sugar-detox diet is no joke and the initial phase is likely to discourage even those with the highest motivation. I observed that, if properly done, it takes from one to three weeks to get rid of sugar dependency from a metabolic point of view: this is what is needed for most people to restart the far-burning pathways. In short: it is tough, but it can be done.


Dysregulated taste...

Getting rid of the taste-dependency from sugars instead, that's another thing.

There is a (very unhealthy) growing tendency in adult people to keep looking for food that tastes sweet. This fact remembers me a blog post I read five years ago, complaining about this trend: how almost nobody today can, for example, simply drink a black coffee. It has to be somehow edulcorated. Quoting:

"Now coffee comes in a myriad of flavors including vanilla, caramel, cinnamon, and peppermint."

Or, tea. Quoting again:

"Take iced tea for instance, whereas older people tend to enjoy unsweetened tea, younger people cannot palate it without some sort of sugary substance."

His major complaint however was on alcoholic drinks, quoting:

"as a whiskey aficionado, I was stunned to see apple and cinnamon flavored whiskeys creeping onto the shelves. Only then did I realize whiskey was also beginning to undergo a sweetness transformation"

Which is what we see today, even in healthy circles:
  • People don't eat meat, they eat protein bars, shakers and meal replacements that taste chocolate, caramel and vanilla
  • Blogs about healthy recipes contain more desserts than main courses and side dishes
  • Mid-morning and mid-afternoon snacks are... sweet treats.
  • Cheat days are for... sweet treats (or abuse of carbohydrates like pasta or pizza)
While protein bars and homemade desserts are often better than an industrial donut fried in rancid sunflower oil, what is missing in this scenario is the need for re-education of taste buds, from an preference for the sweet taste (typical of children) to a preference for bitter, salty, sour and umami (typical of adults).

As long as this is not resolved, one will always crave sugar and, with a growing numer of researches showing that alternative sweeteners are unhealthy, that can potentially be an issue. It had already been an issue in the past (external link, worth reading).


Psychological dependency for forbidden food

Often, this does not cause cheat days but instead replacements. I see this a lot:
  • vegans crave meat and cheese (that's perfectly normal, we have a taste for umami). This is where an extraordinarily flourishing industry of fake-meats and fake-cheeses is literally making billions out of this newly created problem which takes advantage of an ancestral and hardwired (hence not easily disposed) physiological need.
  • paleo-dieters and the gluten/lactose-free tribe crave bread and dairy, again ending up in grotesque replacements on which I don't want to spend any more words.
Some don't replace and simply decide to cheat occasionally, actually doing themselves more good than harm.


Poor cooking skills when cooking healthy

A lot of people recently jumped onto the healthy-eating wagon, and that is just fantastic: there is a more and more widespread awareness of the role played by what we eat on our health. Unfortunately, often, they are confronted with lack of cooking skills. It's ok: I wasn't born with a chef's hat neither.

Because of this, they end-up eating recipes with such low organoleptic properties that the only solution not to go insane is to wait for the weekend or for a social event to cheat on junk food. Stated this way, it is obvious to everybody that something is wrong with this approach: your weekly menu should not be so unsatisfactory to let you frustrated thirteen meals out of fourteen.

I personally went through this and know that there is only one solution: learn to cook. One of the things I wanted to avoid in my blog was to make it a recipe blog, however I recently opened a Facebook Page, too. I plan to start publishing recipes there.


The 80/20 rule


A case against 80/20

In healthy eating circles, the 80/20 rule is becoming very popular. The thesis is that if you eat healthy 80% of the time, this allows for a 20% of freedom.

The first question that comes to mind is:

Freedom from what?

The mindset itself is wrong and it is the heritage of a culture dating back to the Eighties, when we have been cheated into believing that eating healthy must perforce be a torture, a stoic proof of superhuman self-control where all the delicacies are forbidden and all what is allowed is chicken breast and white rice. Needless to say, it is once again a problem of cooking skills.

The second question is more intriguing:

Why would anybody want to do 80/20 at all?

I'll make a practical example to explain how I see it:
  • our hands have 10 fingers
  • we deliberately hammer two of them
  • we still have eight healthy fingers, which are enough to perform most daily activities
Again, stated this way, it becomes evident that the approach is non-sense: only a masochist would want to have less than 10 healthy fingers, even if 8 still allow to write a letter, drive a car, type a keyboard, etc.


A case in favour of 80/20

That said... shit happens. We don't always have control of the situation and we may have to eat something we haven't cooked ourselves or the menu in the restaurant doesn't have options that fit our regimen. And guess what?

That's fine!

I believe the 80/20 rule is true. If one is healthy, his or her body is perfectly capable of handling the occasional not-so-perfect meal.

Back to the 10 fingers example: we do our best not to break any finger but... should we break one or two our body will fix them.


Bonus paragraph: trivia on the 80/20 rule

When speaking about the 80/20 rule, some people invoque the Pareto Principle, hoping to gain more credibility by doing some scientific talk.

Unfortunately they didn't get it right: if we want to apply it correctly, what Pareto truly says is that 80% of the damage is caused by 20% of what you eat.


Orthorexia

This post wouldn't be complete if I didn't spend some words on orthorexia.

As I mentioned before, more and more people are realizing that eating 2000KCal of junk food is not the same as eating 2000KCal of Mediterranean Diet. We live in a time when we have to be particularly careful and well-informed with regard to the choice of what is in our dishes, in particular its origin, and knowledgeable about the correct preparation processes. Sounds logic. However, instead of being encouraged, this behavior has been proposed to be recognized as a psychiatric disorder, luckily it hadn't been accepted (for the moment).

My personal point of view is: making informed decisions on what we eat (and when, how and howmuch) in order to avoid disease and feel better, this is not an eating disorder: that's intelligence and insightfulness, Basing decisions on shame, or guilt, or self-exteem issues, or trends, or not basing one's decision at all and eating randomly... those are eating disorders.

In short, orthorexia is way over-sensationalized and I think (being caustic here) that this is just the last desperate attempt of a corrupt food system to keep us away from adopting healthy eating habits. I am worried about the day when psychiatrists will start diagnosing orthorexia as a fully recognized disorder and will recommend a therapy based on fast food, twice per day.


Conclusions

Okaaay, yeees... It is possible to eat unhealthy once in a while and still enjoy all the benefits of eating unpeccably the rest of the time.

We don't have to freak-out because the gourmet chef used a spoon of wheat flour as a thickener in a stew, our bodies can pretty much handle the occasional contumely: honestly, if it were that easy to become intoxicated there wouldn't be a single organism alive on this planet anymore.

However, it should not be a planified cheat day... that would be the equivalent of looking forward for the weekend to deliberately break a femur.

The ideal exception is represented by the case when we don't have a choice: either we are invited, or the restaurant we are going to has no alternatives. People break bones everyday, it happens... that's life. In healhy people bones repair: this is life, too.

The take-home message of today is:

Eat healthy whenever you are in control of the menu
Be in control of the menu as often as possible
Accept the compromise when you have to

And stay tuned: here there are no exceptions allowed!

Sunday, October 30, 2016

Popular diets



I long hesitated before I decided to write this article. The main reason is that I want to be a proponent, not a criticizing naysayer. And speaking about recent popular diets automatically turns into criticizing them.

However, it had to be done. When faced with questions like "do you think the xyz-diet is healthy" I keep repeating the same stuff over and over again, so... what's more practical than writing down everything and referring people to my blog?

So, here we go. A long post on what is good but also what is wrong in recent popular diets. Read it in sections.


Vegan


Don't get me wrong, I don't want to convert anybody into eating carcasses. I already mentioned elsewhere that I didn't invent the rules, I just know them and my role is only to inform, so don't blame me for being honest: blame evolution.

A vegan diet removes a priori every product that is animal in origin, including meat/fish/eggs/milk but also honey, leather, fur and cosmetics tested on animals. As vegans will tell you: it is more than a diet, it is a lifestyle.

The approach is clearly dogmatic, but I am not here to criticize that point of view, everybody has the right to follow the ethics they feel better for themselves. I am here to speak about nutrition as a science.

The most common critique that everybody makes to a vegan is:

Where do you get your proteins?
(imagine I said it in falsetto)

I will speak in favor so we settle this immediately: proteins are found everywhere!

Good plant-based sources of proteins (which I myself eat regularly and in quantities) are:
  • pulses (beans, chickpea, lentils, green peas, faves, ...)
  • nuts (almonds, cashew nuts, pecan, walnuts, hazelnuts, ...)
  • seeds (pumpkin seeds, chia seeds, hemp seeds, pine seeds, ...)
  • pseudo-grains (amaranth, quinoa, buckwheat, ...)
  • whole grains (rye, oat, ...)
  • ... and, to a lesser extent, in a number of other vegetables (asparagus for example)

The fear of being low in proteins (and the fact that humans have an hardwired taste for meat...) often brings vegans to eat the so called meat-replacements. Below is an incomplete list, just to give an idea:
  • soy products (tofu, soy-burgers, soy-milk, soy-yogurt, etc)
  • quorn (it comes in the form of sausages, pseudo-steaks, etc, ...)
  • spirulina

Let's see why I don't recommend them.

Soy

Contrary to popular belief (a belief enforced not by scientific evidence but instead by a hammering marketing campaign...), soy is not an healthy option.

This list of reasons kindly provided by the WAP Foundation should be enough to enlighten most readers:
  • High levels of phytic acid in soy reduce assimilation of calcium, magnesium, copper, iron and zinc. Phytic acid in soy is not neutralized by ordinary preparation methods such as soaking, sprouting and long, slow cooking. High phytate diets have caused growth problems in children.
  • Trypsin inhibitors in soy interfere with protein digestion and may cause pancreatic disorders. In test animals soy containing trypsin inhibitors caused stunted growth.
  • Soy phytoestrogens disrupt endocrine function and have the potential to cause infertility and to promote breast cancer in adult women.
  • Soy phytoestrogens are potent antithyroid agents that cause hypothyroidism and may cause thyroid cancer. In infants, consumption of soy formula has been linked to autoimmune thyroid disease.
  • Vitamin B12 analogs in soy are not absorbed and actually increase the body’s requirement for B12.
  • Soy foods increase the body’s requirement for vitamin D.
  • Fragile proteins are denatured during high temperature processing to make soy protein isolate and textured vegetable protein.
  • Processing of soy protein results in the formation of toxic lysinoalanine and highly carcinogenic nitrosamines.
  • Free glutamic acid or MSG, a potent neurotoxin, is formed during soy food processing and additional amounts are added to many soy foods.
  • Soy foods contain high levels of aluminum which is toxic to the nervous system and the kidneys.

For those interested to read further about this topic, I recommend The list of myths and truths about soy, and for a long read The Ploy of Soy. You'll notice that some of these documents are older than 20 years and still topical, yet you probably never heard about them. What you heard in the last 20 years is the hammering marketing campaign.

Quorn

That's an intriguing one. Quorn is a meat-like substance made from textured proteins from a fungus (Fusarium venenatum).

A consistent number of people accuse reactions after eating quorn. Additionally, it has been introduced very recently and no traditional culture ever ate quorn before.

Is it safe at all? I don't have the answer yet... but considering what happened until now, every time a non-traditional food had been introduced and became mainstream, my take is that we will have some news soon or later.

Spirulina

Spirulina is a cyanobacterium (either Arthrospira platensis or Arthrospira maxima). used as a dietary supplement as well as a whole food. It is available in tablets, flakes and in powder form.

Dried spirulina contains in average 60% proteins. I underlined the word dried because often people make the comparison between 50 grams of dried spirulina and 50 grams of raw meat to prove that the first contains more proteins than a steak: this is an example of those situations where common sense falls apart and all what matters is proving one's credo, to the detriment of good science.

The reality is that, from a nutritional point of view, spirulina is no better than other sources of vegetable proteins, but is way more expensive for the consumer (again, the hammering marketing).

Let alone the price, spirulina has been shown to have a number of side effects:
  • Contains cyano-cobalamine (unsurprisingly, since it is a cyano-bacterium). This impairs the absorption of methyl-cobalamine. More details in the next paragraph.
  • Worsens phenylketonuria. Phenylketonuria is a genetically acquired disorder, wherethe patient cannot metabolize the amino acid called phenylalanine due to the lack of an enzyme named phenylalanine hydroxylase.
  • Spirulina boosts the activity levels of the immune system. Wait.. so it is good? Yes and no, actually... not for everbody: this poses a threat of drug interaction, especially with immune-suppressants. Spirulina and immune-suppressant drugs work in a contradictory manner.
  • Since it up-regulates the immune system, it also exacerbates the symptoms of autoimmune diseases.
  • Risk of heavy metal toxicity. Varieties of spirulina that are produced under unrestrained settings are often infested with significant traces of heavy metals, such as mercury, cadmium, arsenic and lead. The source matters.
  • Renal disorders. A large amount of ammonia is produced in the body as the protein in spirulina is metabolized (those who attended my live workshops know what I am speaking about: it's the bicycle experiment)
  • Digestive discomfort. Consuming spirulina can lead to synthesis of digestive gases in excess amount, causing abdominal cramps and flatulence.
  • Septic shocks. It is quite possible for spirulina to be infested with toxin-producing bacteria
  • Risk of acquiring Motor Neuron Disease (MND). Spirulina harvested from the unrestrained wild sources, such as lakes, ponds and sea are often toxic in nature.
  • Risk for pregnant women and breastfeeding infants. The side-effects of spirulina on the normal course of pregnancy are yet to be discovered.

The above list can be translate into English like this: as is the case of quorn and other recently introduced superfoods, spirulina still has a long way to go before it can be declared safe.

Last but not least, while I have never tasted it myself and probably never will... it doesn't even look appetizing. I'd rather have a beans salad instead.

Not only proteins

So, are we done? Of course no! Although essential, the body doesn't need only proteins to stay healthy. Here is a list of other nutrients that are essential for humans and which people on a extremely rigid vegan diet may be deficient in:
  • Retinol (Vit-A)
  • Cholecalciferol (Vit-D3)
  • Menaquinone (Vit-K2)
  • Methylcobalamine (Vit-B12)
  • Medium and long chain omega-3 fatty acids (EPA and DHA)
  • Iron
  • Calcium
  • Coenzime Q10 (CoQ10)
  • Carnitine (Vit-BT)
  • Creatine (Vit-B20)
  • Conjugated linoleic acid (CLA)

Retinol

Retinol is the only active form of Vitamin A, all other forms are called carotenoids and are to be considered precursors to the real Vitamin A.

The body has a limited ability to convert carotenoids into retinol, with the usual distribution where some people can convert enough of it to stay healthy, some hardly cover the needs and some others have an impaired conversion and cannot meet the requirements at all. Regardless your natural predisposition to efficiently make the conversion, it is indeed a vitamin that we have to introduce in our bodies through our diets.

The bad news for vegans is that retinol is only found in animal products, such as eggs, liver, dairy and oily fish. Whenever you are reading a blog that recommends carrots because they are rich in vitamin A... change your source of information.

Cholecalciferol

The preferred source is universally considered to be sun exposure. The Vitamin D3 is an hormone that our body produces from cholesterol in our skin whenever we suntan. Unfortunately, unless you live in the tropics, a year-long vitamin D3 coverage from sun exposure alone is impossible, and must therefore be provided  through the food we eat.

Contrary to popular belief, nuts and seeds are not a good source of the same, as they contain vitamin D2. Good sources of D3 are eggs, liver, dairy and oily fish. One notable exception is Cladonia arbuscula (a lichen, yummy...).

Menaquinone

Vitamin K2 is the third indispensable vitamin needed for calcium metabolism. Without it, the calcium absorbed in the intestine will not go into the bones, but instead calcify soft tissues (atherosclerosis).

Although many websites report that K2 is only found in animal fats, this is not true. This vitamin is produced by bacteria through lacto-acid fermentation. A minimal amount can be synthesized directly in your large intestine by friendly bacteria. Vegetable sources of K2 are:
  • lacto-fermented pickles
  • natto... Yes, it's soy. However, fermented soy has less side effects. Alternatively: learn to prepare homemade natto from chickpeas (it's easier than you think)

Methylcobalamine

This is the most famous critique against vegan diets. It is so true than vegans themselves acknowledge it and supplement accordingly. I won't develop this topic further if not to make a clear distinction between two forms of cobalamine:
  • methyl-cobalamine (what our body actually needs)
  • ciano-cobalamine (a look-alike of the true B12 that doesn't have the same metabolic functions)

Some plants and algae, and the above mentioned spirulina, contain cyano-cobalamine: they are not a source of B12.

Many supplements contain ciano-cobalamine instead of methyl-cobalamine. If you choose to supplement, do it wisely.

Omega-3

That's another topic where is a lot of confusion about. I already mentioned it in other posts, but it is worth repeating:
  • ALA is the short-chain omega-3 fatty acid that is essential for humans (we cannot manufacture it from scratch or from other fats)
  • humans can indeed convert ALA into DHA and EPA (medium and long chain omega-3 fatty acids)
  • however, like it happens with Vitamin A, the conversion is extremely inefficient and for the majority of people it doesn't cover the essential needs, making these two important fats conditionally essential. In old people, for example, this conversion is very low.
  • as a consequence, it is extremely important to introduce these two with our diets

There is a catch... DHA and EPA are only contained in animal products, ALA being the omega-3 fat contained in plants like chia, flax and hemp. A notable exception is a GMO breed of the plant Camelina which had been recently engineered to produce DHA and EPA.

Once again, it is important to be well informed, and most people are really badly informed: vegetable oils are touted as sources of omega-3, but their fatty acids profile is not complete. This may leave some individuals who opt for a strict vegan diet, with severe deficiencies. This is particularly true for growing children and elderlies: the brain needs omega-3 fatty acids.

Iron

Iron is better absorbed in the intestine when it is in heme form, which is the form of iron found in animals.

However, Vitamin C greatly improves the absorption of iron, and a vegan diet eating plenty of fresh vegetables and fruits is particularly rich in this very vitamin, so these two facts may balance themselves.

On the other side, calcium and iron compete for absorption: a meal containing the two may reduce iron intake. Yes, nutrition is complicated...

Calcium

Badly driven studies came to the conclusion that milk causes osteoporosis. This is total non-sense and will be discussed in a dedicated post which I will do with the aid of a person better qualified than me to speak about milk (stay tuned).

Other myths and legends claim that broccoli have a higher calcium content and are therefore a better source of this mineral. I will add something to this: limestone contains even more calcium, does this undeniable fact make calcareous rocks the ultimate calcium supplement? Obviously no, there is again some confusion between the presence of a nutrient in a food, its absorption and its bio-availability in metabolic processes. Guess what you need to absorb and use calcium? Vitamins A, D3 and K2, none of them are found in broccoli (or limestone) but are present in the correct proportions in milk.

It is not that you can't absorb and use calcium from broccoli (or limestone), just make sure you meet your requirements of fat soluble vitamins through other sources of through supplementation.

Coenzime Q10, carnitine, creatine, CLA...

These micronutrients, and many others I didn't mention, are not essential vitamins. In the sense that our body can often produce enough of them. They are also found in vegetables, although in small quantities.

Nonetheless, studies showed that introducing them through diet, and so removing the burden of producing them from our body, has a number of health benefits.

Conclusion: can you be healthy on a vegan diet?

My favorite answer to this question is:

You can be healthy despite (and not thanks to) a vegan diet

This usually upsets my interlocutors with heterogeneous reactions, including unfriending me from Facebook. Had she decided to stay for the second part of the answer, she would have discovered what follows:
  • you can be healthier that most people who are eating junk food, and this is no brainer: every diet is better than a junk-centric diet
  • however, lack of disease is not synonym of thriving: a well balanced omnivorous diet will always top a well balanced vegan diet
  • according to your biochemical individuality, make sure you are eating enough proteins. Don't listen to the irresponsible guru telling you that proteins are dispensable. As we saw, meeting the requirements is totally possible with a vegan diet
  • don't fall into the trap of pre-packaged "healthy" vegan meals and snacks. Prepare your recipes from the bare ingredients and enjoy total control over what you eat
  • some micro-nutrients cannot be found in a 100% plant-based diet, make sure you supplement accordingly for the required ones
  • in any case, always listen to your body. Don't lie to yourself just to follow a dogmatic dietary approach and even more important: don't do it in order not to disappoint the rest of the tribe. When it doesn't work, it doesn't work.

What lessons can we learn from a vegan diet?

All diets, despite many differences, agree on this one thing: we should eat more fresh vegetables, and a well balanced vegan diet makes vegetables the staple.

Although I am omnivorous, I regularly read vegan websites and forums to learn some tricks, I believe it is important to always maximize the nutrient density of what we eat and ideally we should try to get the best of the two worlds.

Another no less important lesson regards animal welfare and ethical treatment of animals.


Vegetarian (eggs and dairy)


This is according to science (so not in my opinion) the minimal set of food required for proper health and possibly even for thriving.

Following everything I said for the vegan diet, a vegetarian diet adds:
  • Eggs, source of Vit-A, D3, K2, B6, B12, DHA/EPA, iron
  • Milk, souce of Vit-A, D3, K2, CLA and calcium

Conclusions: can you be healthy on a ovo-lacto-vegetarian diet?

Definitely yes, although there is still the risk for some individuals to be low in essential fatty acids.

The source is also very important: milk from grass-fed cows and eggs for cricket-fed chicken have a vastly superior nutritional content than grain-fed cows and chickens. As a consumer, you have the ability to make the change happen: it is the demand that drives the offer, not the other way around.


Ovo-lacto-pesco-vegetarian


This is obviously even better than a standard vegetarian diet, with the inconvenient that, yes... this time we are indeed killing animals to get our food.

What makes a pesco-vegetarian diet so interesting?
  • Fish is the ultimate source of medium and long chain omega-3 fatty acids, together with liposoluble vitamins A, D3, K2
  • If you opt for small fish you can easily eat their soft bones (a source of calcium).
  • Fish also contains good quantities of B12, zinc and iron.

If your concerns are just ethical, you should consider eating seashells. Those animals lack a central nervous system and technically they are "plants made of flesh". Oysters in particular are very rich in B12, omega-3, iron and zinc. Something to think about.

Conclusions: can you be healthy on a ovo-lacto-pesco-vegetarian diet?

Several traditional cultures have been thriving on this very diet for millennia, so the answer is obviously yes.

Same observations as for the ovo-lacto-pesco-vegetarian diet: choose local and organic produce, or wild caught fish. Again, this is not what the supermarkets want to propose you, but you as a consumer can make the difference.

Trivia

Anybody noticed that ovo-lacto-pesco-vegetarian-diet is just a tongue-twister to say Mediterranean Diet?


Paleo


A-ha... I'll be lucky if I still have friends at the end of this paragraph.

The Paleo Diet is another dogmatic diet. It is basically an elimination diet which discourages eating the food from the agricultural revolution, namely: grains, pulses, refined sugar, vegetable oils and dairy. A lot of emphasis is put on in-season fresh vegetables and fruits from local produce and organic meat, eggs and fish.

Although dogmatic, the idea works! People on a well balanced paleo diet indeed thrive and a considerable number of testimonials confirm having resolved health issues such as:
  • obesity (some before/after pictures are simply jaw-dropping)
  • irritable bowel syndrome
  • metabolic syndrome
  • allergies
  • skin rashes, eczema
  • ... just to name a few

In short, while not being paleo myself, I admit that among the recent diets, this is probably one of the most sound. However, as usual, you can also do it the wrong way, let's see why: typical errors of paleo diet adopters.

Packaged food

The Paleo Diet has recently become a major trend, you can easily tell it not only because every magazine, television shows and "that guy at the gym" talk about it, but also because there are more and more "paleo approved" packaged food offers. I won't develop this point any further, anybody able to understand my point doesn't need me to explain it. Those unable won't get it anyway.

Bacon (and muscle meat in general)

One of the favorite food of paleodieters is bacon.
  • Tasty? Yes, only a fool would disagree.
  • Unhealthy? No, despite what they told us over 30 years ago.
  • Healthy? Neither! Cured meat is not a healthy food. Bacon should be considered an innocent but occasional treat, not the base of the new pyramid!

Muscle meat is another staple of many of those doing the paleo diet the wrong way. The muscle is the animal cut with the higher content of proteins per weight. However there is an imbalance between two amino-acids: methionine and glycine.

Excess of methionine depletes the stores of Vit-B6 and Vit-B12 and may raise the levels of homocysteine in the blood (and inflammatory amino-acid) whose high levels represent a risk for heart disease. Ironically, high homocysteine levels is also a common condition amongst vegans and vegetarians.

Glycine is found in connective tissues like skin, tendons, ligaments, in bone broth and internal organs. Internal organs are also the most nutrient-dense part of the body: they may have less proteins per weight but are rich in vitamins and minerals.

Think like a real caveman: you ran 10 miles to chase down a 1 ton aurochs... don't get just the filet and throw the rest: eat nose to tail.

Replacements

Like it happens for vegans and vegetarians, it is sometimes difficult to abandon overnight some commodity foods you have been eating for a lifetime to go back to what real cavemen actually ate: enter replacements. For the paleo diet this usually involves substitutes to the forbidden wheat flour and milk. I already expressed here my concerns.

Treats

Another source of bad information are the recipe blogs animated by paleo enthusiasts, 99% of the time they are people with no clue what nutrition is about. A considerable part of their recipe sections is dedicated to paleo-approved cakes, biscuits, spreads, semi-freddos, and so on.

With all those sweets, I think we finally discovered the reason why cavemen died at such a young age!

Ok seriously now: dear Jane, dear Joe... you can't live of treats, no matter how paleo they are. Eat Real Food.

The weakness of the dogmatic approach

The dogmatic approach of removing agricultural food (cereals, pulses and dairy), misses one important detail: while it's true that you can live without, most of these food are healthy and nutritious when properly prepared. And that will be the topic of my next post.

Low-carb paleo

Check the dedicated paragraph, below.

Conclusions: can you be healthy on a Paleo Diet?

Yes, provided you are on a genuine paleo diet, not on some grotesque version of it dominated by fried bacon, coconut milk, almond muffins, almond crust pizza and paleo-approved treats.

What lessons can we learn from the Paleo Diet?

In my personal opinion, the merit of paleo has been to courageously challenge the established common wisdom on the following myths:
  • that grains are to be considered the staple of human diet
  • that fats are unhealthy: the less, the better
  • that meat, and in particular red meat, is unhealthy
  • indirectly, it exposed the problems of the current ways of preparing cereals, pulses and dairy


Primal


Some people choose a more relaxed version of the paleo diet, which includes dairy products, preferably grass-fed, full-fat and raw.

Once you get rid of the pre-concept that milk is bad for you (hint: skimmed, homogenized and pasteurized milk is bad for you), and embrace the studies of Weston A. Price who reported that among primitive cultures, those enjoying superior health where those which introduced dairy in their diet... it makes totally sense for me to conclude that everything good (and bad) I said about the paleo diet can be re-confirmed for the primal diet.

Conclusions: can you be healthy on a primal diet?

Definitely yes. If milk is tolerated it can even be healthier than the paleo.

Same risks of doing it the wrong way, thus...


Low-carb-high-fat


I already exposed the advantages and dangers of low-carb diets in a previous article.

LCHF diets such as the Atkins, Dukan and some interpretations of the paleo diet are becoming more and more popular and for a reason: people are extremely pissed-off because of the demential advice that we had been sold for the last four decades: to reduce fats to the minimum and draw a uniform block of starches at the base of the infamous food pyramid.

The discovery that fats don't make you fat (sugars do) had been an epiphany for a lot of people, with two major currents forming:
  • those who got it right and eliminated refined sugars, while adding healthy fats and proteins in their diet
  • those who bought the idea that being in ketosis is the natural state for humans, reduced their carbohydrates intake below the mythical 50g per day and keep testing their urines 10 times per day to make sure they stay in ketosis

Ke... keto... say whaaat?

Ketosis

Ketosis (not to be confused with ketoacidosis) is a metabolic state in which some of the body's energy supply comes from ketone bodies in the blood, in contrast to a state of glycolysis in which blood glucose provides most of the energy. Ketone bodies are produced by the metabolism of fats.

English translation: you use fat for energy.

Does it work for weight-loss? You bet it does! Once again, plenty of people experienced stunning results, with before-&-after pictures to witness them.

Is it healthy in the long run? That's another story. While it is common sense that we had been eating too many carbohydrates, moderation should drive our choices. I explained already how the food we eat are messages we send to our body, so if you still are not convinced just refer to my previous article.

Ketosis is an important therapeutic protocol for epilepsy, diabetes and it is proving its validity to support cancer therapy. Healthy people can experience benefits, but also drawbacks.

Conclusions: can you be healthy on a LCHF diet?

I am more prone to recommend an individualized carb diet:
  • those who are very active need more (forget the fat-burning-beast market claim)
  • people not moving a single finger throughout the day, need less
  • patients trying to lose weight or with blood sugar imbalances could benefit eating less
  • those with adrenal exhaustion definitely need to modulate carbs intake (in particular fast sugars): not too much, not too little... funny enough the reason for both is the same: avoid hypoglycemia
  • people with non-autoimmune forms of hypothyroidism should not attempt a low-carb diet (hint: fix the adrenals first)


Low-fat


Could I forget to mention the low-fat diet?

As strange as it seems, and despite the huge body of evidence that fats are good for you, I still meet people with 0.001% yogurt in their baskets, at the supermarket.

As I said in a couple of old posts ([1], [2]), a consistent quantity of good quality fats should be eaten regularly for optimal health.

Conclusions: can you be healthy on a low-fat diet?

I think evidence speaks for herself. Decades of low-fat craze left us sicker than ever before in human history.


Caloric restriction diets


My professor once said:

Eat less and move more... if only it were that easy!
We would have solved the issue 40 years ago!

And, as usual, he was right.

Caloric restriction diets are always in fashion, the reason for it is obvious and I should not even mention why. And the reason is (just in case): in order to take from the reserves, you need to create an imbalance between what you eat and what you burn. This is thermodynamics, so far so good.

There are therefore two possible paths:
  • eat less than you burn
  • burn more than you eat

Eat less

We all agree that overeating is not a friend of weight loss. What about undereating?

Nutrition is not only about calories, proteins, carbohydrates and fats. Nutrition is also about minerals, vitamins and all the plethora of other micronutrients that are found in real food. The first and most dangerous risk of following a low-calories diet, especially for long periods, is being undernourished, in the sense of being unable to meet the recommended intake of micronutrients.

I already explained why making-up with supplements is not a good idea, so I'll just refer to my previous article.

Eating less also slows down the basal metabolism, causes muscle loss and in the long term may down-regulate the thyroid (and so permanent weight gain).

My recommendation:

Move burn more!

Yes, the secret is not to move more, but to burn more.

If these two seem synonyms, it is not your fault. One again you have to blame the hammering marketing of a fitness industry that for 40 years transformed all of us into some kind or mindless chronic cardio addicted. Yes, I've been in that hell, too.

Why it doesn't work? Chronic cardio only burns while you are doing it, so you need to do plenty of it for burning a lot of calories. However, long cardio sessions cause chronic low-grade inflammation, which stimulates the production of cortisol (a catabolic hormone) which causes muscle loss and water retention. Long sessions also stimulate appetite, often more that what you burned.

Weightlifting or bodyweight strength training exercises, instead, have the advantage to raise the basal metabolism (so you burn more throughout the day, even when you are sleeping). It is also the kind of training that triggers the production of testosterone (an anabolic hormone) which in turn causes muscle gain. More muscles: more calories burnt. Short sessions stimulate the appetite, but much less than long ones: I regularly find myself eating less than I should, even after an intense - but short - workout.


Gluten free


This is an interesting one. Worth spending some words.

Gluten is a generic name for a family of proteins found in cereals, in particular wheat. They are responsible for providing the characteristic mechanical properties of a dough when it is kneaded and that's what allows to make a loaf with big holes. Gluten is also a very controversial ingredient in people's diet.

Celiac disease

Celiac disease is an auto-immune condition characterised by a genetic predisposed allergic reaction to gluten, in the small intestine.

Celiac disease is real and can be tested. The estimated incidence on the population is 0.5-1% in developed countries. If you are reading this blog I assume you are in a developed country.

For people with celiac disease, going gluten free is a must to avoid serious complications.

Non Celiac Gluten Sensitivity

What about the other 99%?

It has been proposed that a condition called non-celiac gluten sensitivity is present in a large percentage of the population. Symptoms can range from GI discomfort to fatigue and other neurological issues.

The existence of NCGS would explain the benefits shown by those who went gluten-free (in particular paleo-diet adopters) and although they are often mocked that "their sensitivity is all in their head", blood tests don't lie: for some people going gluten-free really provided health benefits.

But was it the gluten? Or is there something else in wheat or in the subjects themselves that can trigger those symptoms?

According to me (when my take is not ultimately supported by current science I'll always say it): gluten free is not a fad, but not perforce because gluten is being removed. Let's see why I think this:
  • Today's wheat is not the wheat we used to eat 100 years ago. It is indeed richer in gluten and not only: a stronger type of gluten. Often gluten sensitivity disappears when people try other types of cereals such as rye.
  • Today's bakery products do not follow the traditions. Again, gluten sensitivity disappears when people start eating homemade sourdough.
  • The reaction may be to other substances contained in wheat, both natural and artificial (pesticides and herbicides for example).
  • People with NCGS also happen to have leaky gut, a condition where partially undigested proteins may leak through the small intestine directly into the blood stream. Is it a coincidence that those with NCGS are also sensitive to milk, eggs or even coffee? If this is the case, removing gluten is like an ostrich hiding its head in the sand. The root cause is a highly permeable gut that lets everything go through, THAT should be the NUMBER ONE priority! In this case, a good holistic nutritionist can help.
  • Well... I may indeed be in your head! How many people are ssso gluten sensitive, but once in a while binge on white bread because "it comes and go, this week it's fine"? Or can eat seitan because they don't know it is pure gluten?

Last but not least, I don't trust very much recent researches. There is a huge interest in convincing people that gluten is the ultimate villain in order to sell expensive gluten-free products and bread replacements to self-diagnosed gluten-sensitive consumers. The following list is an example of ailments, diseases and conditions attributed to gluten:
  • Irritable bowel syndrome
  • Fibromyalgia
  • Dermatitis and other skin conditions
  • Multiple sclerosis
  • Peripheral neuropathy, myopathy, and other neurological disorders
  • Schizophrenia
  • Depression
  • Attention deficit hyperactivity disorder
  • Ataxia
  • Type 1 diabetes
  • Autism spectrum disorders
  • Ménière disease
  • Endometriosis
  • Insulin resistance and inflammation
  • ... being obnoxious at social events (this is mine)

When there are too many heterogeneous conditions associated to one single food group or (like in this case) a single molecule... I am always very skeptic.

Conclusions: is gluten free a fad or not?

My personal opinion: yes and no.

It is totally possible to live without pasta, bread, pizza, biscuits, grissini, bruschetta or morning cereals. I even recommend to try ditching grains and derivates to see how your body responds. Just don't fall into the trap of comic bread replacements.

However, concerns about gluten are overly amplified for the marketing reasons I mentioned before, so in the end the ultimate judge whether or not it is a fad is you, and your personal investigations.

Also try the traditional methods for preparing cereals: if in doubt just stay tuned because I will soon speak about this.

If you suspect NCGS, try getting an appointment with a good holistic nutritionist or naturopath. It may be leaky gut.

Finally: listen to your body, not to bloggers (not even to me).


Intermittent Fasting


Intermittent Fasting is another protocol which is getting more and more popularity. There are several formulas, but the most common is: two meals per day (lunch and dinner) followed by a 16 hours fast.

It work pretty well for weight loss and for muscle gain for tree reasons:
  • people instinctively eat less (so it is a calories restriction diet)
  • in the last hours of the fasting phase, the subject may be in a mild ketosis (so fat burning mode)
  • endogenous somatotrope hormone (HGH, Human Growth Hormone)

Human Growth Hormone
Usually, doing a short but intense workout at the 15th hour, before breaking the fast, stimulates the release of HGH. This hormone serves two roles:
  • breaking down fats for energy
  • it is an anabolic hormone, and it is 100% natural

English translation: you burn fat and you build muscle.

Again, I am not saying it doesn't work. Hundreds of photo galleries show the impressive gains of intermittent fasters.

I may be wrong but in my opinion it is not safe in the long run: fasting is part of our genetic heritage, but alerting the adrenals on a daily basis with low-glycemic events means messing-up one's endocrine system. For what? A six-pack?

Use with care, like any other diet...


Final words


Yes, this time it was a very long article, and it was not even complete. I haven't mentioned diets such as:
  • blood type diet
  • chrono diet
  • raw-foodism
  • the volumetric diet (eat tons of fiber and water-containing food)
  • diets based on multi-marketing products
  • ... breatharianism

These are undeniably fad diets or scams. In my post I decided to cover only the most popular, exposing what are their advantages, their weaknesses and their potential risks.

For all the rest there are other websites that did some excellent analysis already (http://www.quackwatch.com)

Eat well, and stay tuned!

Wednesday, August 10, 2016

On supplements


I am often asked what, as an holistic nutritionist, my position on supplements is.

The topic is quite complex and I cannot reply with a simple “yes their good”, “no their not”. What makes nutrition a very fascinating science is that the answer is always “it depends”.

This is not what people want to hear so chances are that half of the readers will stop reading NOW and look for another blogger who dispenses a more manicheistic opinion. But if you made it to this sentence thanks for your confidence, let me explain.

The correct way to supplement


Supplements are indeed useful in certain circumstances, Even I myself prescribe supplements to resolve some important deficiencies. Some fundamental things to consider are:
  • nobody has the same needs. The recommendation to swallow multivitamin pills like candies is based on the desperate need to sell medicaments to people that wouldn’t otherwise fund Big Pharma
  • supplements are meant to unlock tricky situations where diet alone cannot help. These cases must be identified correctly with the help of a registered dietician or nutritionist (and not by the pharmacist whose main interest is to sell you something)
  • supplements are a temporary solution, not a daily habit to keep all your life in the hope to make to 100yo

Let’s take for example the group of vitamins B:
  • some people may need more vitamins B of this group: (B1, B4, B6, B12)
  • others may require a second group of vitamins B, formerly called vitamins G (B2, B3, B8, B9, choline betaine, lipotropic factors)
The typical multivitamin just tries to provide a good amount of all the vitamins based on the daily recommended values, this obviously cannot work for everybody and to some people this unbalance may even exacerbate their issues. Would you walk in somebody else's shoes? Of course you can give it a try but I am pretty sure it won’t feel good.

Properly prescribed supplements, on the other hand, can be helpful to unlock tricky situations. One typical example I mention is the condition related to low gastric juices' acidity, with all the cascade of issues that this represents:
  • GERD (yes: Gastroesophageal Reflux is caused by lack of acids, not excess of them)
  • bloating
  • SIBO (Small Intestine Bacterial Overgrowth)
  • leaky gut (and so allergies and food sensitivities)
  • and last but not least, impaired nutrients absorption

The last one is important: in order to produce stomach acids the body needs a number of nutrients, one of these is zinc. The irony is that to be able to absorb zinc you need stomach acids. It is a vicious circle and clearly diet alone cannot fix this, supplementation with zinc, digestive enzymes and additional acids is required. And that’s just ONE example, it should start to be clear why do-it-yourself diets don't work.

Then, why not taking supplements all our life anyway?


A-ha… I see where you come from: you want skip the boring healthy food and try to make up for the missing nutrients with pills and fortified snacks. Nutrients need cofactors to be properly absorbed and used in metabolic processes. Some are more famous than others (Vit-C and iron, Vit-A-D3-K2 and calcium, …). Others are less obvious, one example for all.

Ascorbic Acid is a molecule that the FDA decided to call Vitamin C. It is a very important nutrient for our body and although everybody thinks its role is just to calm the symptoms of a flu, its deficiency causes much worse conditions: bleeding gums, epistaxis, poor collagen health (and so weak cartilages, wrinkles…), poor adrenal glands function, etc. It was therefore decided a minimum quantity, called RDA, that everybody should take in order to avoid health complications, and so far so good.

Small problem now: ascorbic acid needs co-factors to be used in metabolic processes. These cofactors are a countless plethora of phytonutrients contained in the plants that naturally contain ascorbic acid itself and are definitely not found in a supplement. If you overdo with isolated ascorbic acid, and especially in the ambit of a poor diet, you can deplete your body’s stores of cofactors, with the consequence that, even in presence of ascorbic acid, you can show symptoms of Vit-C deficiency. How cool's that?

Reality check: the true Vitamin C is not ascorbic acid, but instead ascorbic acid with all its co-factors.

To conclude, the perfect supplement for Vitamin C (ascorbic acid and co-factors) are fresh fruits and vegetables. This holds true for most other nutrients:
  • Vit-A (it needs carotenoids to be used in metabolic processes)
  • Vit-B12 (like zinc, it needs good levels of stomach acids to be absorbed later in the small intestine)
  • Vit-D3 (must be in balance with Vit-A and Vit-K2), never take isolated D3 supplements, take fish oil instead
  • Vit-E (l-alpha-tocopherol is one molecule among many others with similar and complementary functions, most multivitamins contain only this one)

Quality of the supplements


Another issue with supplements is the quality of nutrients contained. I’ll go quick on this paragraph:
  • Vit-D3 (cholecalciferol) is often replaced by Vit-D2 (ergocalciferol)
  • Vit-B12 (methil-cobalamine) is almost always replaced by ciano-cobalamine
  • Vit-K2 (menaquinone) is rarely found in supplements, what you'll find instead is Vit-K1 (phylloquinone). Both are important, but are not interchangeable
  • And finally, vitamins produced per synthesis may present the rests of the solvents used in the production process (yummy...) 

Good supplements exist indeed, they are extracted from plants or from the organs of animals (glandular therapy). They contain the good vitamins and possibly even some cofactors, however they are more expensive: wouldn’t it be a better idea to invest that money in organic food?

Not only micronutrients


Protein powders, BCAA and multivitamins are the heritage of a “gym diet” that was very popular in the 80ies and 90ies. Bodybuilders supplemented for various reasons:
  • because of the wrong idea that the more proteins one eats, the bulkier they will get
  • because their low-fat diet, rich in refined carbs and lean meat (white rice, eggs white, chicken breast), left them seriously deficient in most vitamins and minerals

The “gym diet” recently lost some terrain thanks to the growing awareness of people on the importance of seasonal local produce and nutrient-dense food. Unfortunately some experts are trying to reintroduce them back, often for personal gain: either they have their own gamma of supplemental products or are planning to release it soon. I won’t point the finger: I’ll let you, the reader, the pleasure to rethink the claims of nutrition experts in this new optic.

Superfoods


Another trend are the superfoods, at least these are natural. Every year a new product is launched onto the market with a list of alleged health benefits. I’ll go quick on this one because I consider it the least of the problems: I myself enjoy goji berries sometimes, but not because I believe they have some magical properties. It's because I like them, and blueberries are not available all year long.

Typical characteristics of superfoods are:
  • they are newly discovered, often coming from some exotic location
  • consequently, none of your ancestors ever heard about them but in spite of this they did pretty fine (if you are here...)
  • sometimes they have some intriguing story behind: the monk who lived of goji for example, or the grain found in a hidden chamber inside a pyramid which had been planted and miraculously sprouted… c’mon give me a break!
  • it is cheap to produce but overly expensive for you to buy. Ah, the power of marketing!
  • for some reasons I never understood, they can grow at any latitude and altitude but you still have to import them
  • you are likely to forget about it after some years (mangosteen juice anyone?)

Conclusion


To be clear, I don’t think I walk on waters, but I am pretty sure I can swim better than many experts out there.

These days, with the help of internet and social platforms, the trend is the promotion of quick solutions to achieve health or higher performances (weight loss, clear skin, immune system strengthening, athletic performances, mental clarity, etc).

People don’t want to be sick and I can definitely understand it, that’s why I am so strict on my diet of nutrient-dense properly grown and prepared whole food. Eating liver is not very popular and most people would prefer a combo hotdog/multivitamin instead. The second option may still be better than hotdog alone, but in the optic of what we discussed this would limit your ability to fully express your genetic potential so… why?

In health, stay tuned!