What to eat? Low fat foods, high fat foods…..?

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Meat for sale (tongue and liver) at a traditional market (photo by Erik Peper).

Should I eat vegetables or meats? Should it be steaks or organ meats such as liver, heart, sweet breads? What foods contributes most to heart disease or cancer? Should I change my diet or take medications to lower my cholesterol?

Despite the many years of research the data is not clear. Many  public health dietary guidelines and recommendations were based upon flawed research, researchers’ bias and promoted by agribusiness. Starting in the 1950s there has been a significant change in the dietary habits from eating animal fats to plant based oils and fats. It is so much cheaper to produce plant based polyunsaturated salad or cooking oils (e.g. Wesson and Mazola) and hydrogenated hardened oils  (e.g. margarine and Crisco) than animal fats (e.g., butter, beef tallow, and lard).   Despite the many claims that lowering animal fat intake would reduce heart disease and possibly cancer, the claims are not supported by research data. It is true that consuming liquid plant based oils lowers the cholesterol, but with the possible exception of olive oil, polyunsaturated oils are associated with an increased cancer and death rates in large population studies (Multiple Risk Factor Intervention Trial Research Group,1982; Shaten, 1997).

slider1-2We assume that lowering cholesterol is healthy; however, it is usually a surrogate marker representing a hypothesized improvement in health. A short term apparent reduction in cholesterol levels or other illness markers may mask the long term harm. Only long term outcome studies which measure the total death rate– not just from one disease being studied but from all causes of death–provides the objective results. When looking at the results over a longer time period, there appears to be no correlation between fat intake and heart disease. In fact lowering fat intake seems to be associated with poorer long term health as described in the outstanding book, The Big Fat SurpriseWhy Butter, Meat & Cheese Belong in a Healthy Diet, by the science writer, Nina Teichol. Her superb investigative reporting describes in detail the flawed and biased research that underpinned the United States Department of Agriculture (USDA) and the American Heart Association (AHA) recommendations to reduce animal fats and use more plant based oils.

 

What should I eat now?

Diet recommendations used to be simple: Reduce animal fat intake and eat more plants. Now, there are no simple recommendations because they may depend upon your genetics (e.g., digestion of milk depends whether you are lactose tolerant or intolerant), your epigenetics (e.g., maternal malnutrition during your embryological development is a major risk for developing heart disease in later life), your physical and social activities (e.g., exercise reduces the risk for many diseases), and environment. The recent popularity of the hunter and gatherer diet, often known as the paleo diet, is challenging–it may depends on your ancestors. What hunter and gatherers ate depended upon geography and availability of food sources. The Inuit’s diet in the Arctic consisted of 90% meat/fish diet while the !Kung Bushman’ diet from the Kalahari desert in Africa consisted of less than a 15% meat/fish diet as shown in Figure 1.

paleo-diet-half-baked_3

 

Figure 1. The food content of hunter gatherers varied highly depending on geography. From:  Jabr, F. (2013). How to Really Eat Like a Hunter-Gatherer: Why the Paleo Diet Is Half-Baked. Scientific American, June 3.

Use common sense to make food choices.

  1. Eat only those foods which in the course of evolution have been identified as foods. This means eating a variety of plants based foods (fruits, tubers, leaves, stems, nuts, etc.) and more organ meats. Ask yourself what foods did your forefathers/mothers ate that supported survival and reproductive success. Carnivores usually ate the internal organs first and often would leave the muscles for scavengers.
  2. Eat like your great, great grandparents. They were not yet brainwashed by the profit incentives of agribusiness and pharmaceutical industry. For more information, read the outstanding books by Michael Pollan, The Omnivore’s Dilemma: A Natural History of Four Meals and In Defense of Food: An Eater’s Manifesto.
  3. If possible eat only organically grown/raised foods. Non organic foods usually contain low levels of pesticides, insecticides, antibiotics and hormones which increases the risk of cancer (Reuben, 2010). They may also also contain fewer nutrients such as essential minerals, vitamins, and antioxidants (Barański et al, 2014). The beneficial effects of organic foods have been challenging to demonstrate because it may take many years to show a difference.  Preliminary data strongly suggests that organic foods as compared to non organic foods increases longevity, improves fertility and enhances survival during starvation (Chhabra, Kolli, & Bauer, 2013).  For more information, see my blog, Live longer, enhance fertility and increase stress resistance: Eat Organic foods.
  4. Adapt the precautionary principle and assume that any new and artificially produced additives or chemically processed foods–most of the foods in boxes and cans in the central section of the supermarket–contain novel materials which have not been part of our historical dietary experience. These foods may be harmful over the long term and our bodies not yet know how to appropriately digest such foods such as trans fats (Kummerow, 2009).
  5. Be doubtful of dietary recommendations especially if you know of counter examples and exceptions. For example, the low fat diet recommendations could not explain the French or Swiss paradox (high butter and cheese intake and low heart disease rates). If examples exist, the popular dogma is incomplete or possibly wrong. Be skeptical about any health food claims. Ask who has funded the research, who decides whether a food can have a label that states “it is heart health” and can prevent a disease, and who would benefit if more of this food is sold.

My final comments on nutrition (source unknown).

  • The Japanese eat very little fat and suffer fewer heart attacks than us.
  • The Mexicans eat a lot of fat and suffer fewer heart attacks than us.
  • The French eat lots of butter and drink alcohol and suffer fewer heart attacks than us.
  • The Chinese drink very little red wine and suffer fewer heart attacks than us.
  • The Italians drink a lot of red wine and suffer fewer heart attacks than us.
  • The Germans drink a lot of beer and eat lots of sausages and fats and suffer fewer heart attacks than us.

Conclusion

Eat and drink what you like especially if you enjoy it with company…speaking English is apparently what kills you!

References:

Barański, M., Srednicka-Tober, D., Volakakis, N., Seal, C., Sanderson, R., Stewart, G. B., … & Leifert, C. (2014). Higher antioxidant and lower cadmium concentrations and lower incidence of pesticide residues in organically grown crops: a systematic literature review and meta-analyses. The British journal of nutrition, 1-18.  http://www.ncbi.nlm.nih.gov/pubmed/24968103
Chhabra R, Kolli S, Bauer JH (2013) Organically Grown Food Provides Health Benefits to Drosophila melanogaster. PLoS ONE 8(1): e52988. doi:10.1371/journal.pone.0052988  http://www.plosone.org/article/info:doi%2F10.1371%2Fjournal.pone.0052988

Jabr, F. (2013). How to Really Eat Like a Hunter-Gatherer: Why the Paleo Diet Is Half-Baked. Scientific American, June 3.http://www.scientificamerican.com/article/why-paleo-diet-half-baked-how-hunter-gatherer-really-eat/

Kummerow, F. A. (2009). The negative effects of hydrogenated trans fats and what to do about them. Atherosclerosis, 205(2), 458-465.http://www.atherosclerosis-journal.com/article/S0021-9150%2809%2900208-1/abstract

Multiple Risk Factor Intervention Trial Research Group. (1982). Multiple risk factor intervention trial. JAMA: The Journal of the American Medical Association, 248(12), 1465-1477. http://jama.jamanetwork.com/article.aspx?articleid=377969

Pollan, M. (2006). The Omnivore’s Dilemma: A Natural History of Four Meals. New York: Penguin Press. ISBN: 1594200823

Pollan, M. (2009). In Defense of Food: An Eater’s Manifesto. New York: Penguin Press. ISBN: 978-0143114963

Reuben, S. H. (2010). Reducing environmental cancer risk: what we can do now. DIANE Publishing. http://deainfo.nci.nih.gov/advisory/pcp/annualReports/pcp08-09rpt/PCP_Report_08-09_508.pdf

Shaten, B. J., Kuller, L. H., Kjelsberg, M. O., Stamler, J., Ockene, J. K., Cutler, J. A., & Cohen, J. D. (1997). Lung cancer mortality after 16 years in MRFIT participants in intervention and usual-care groups. Annals of epidemiology, 7(2), 125-136. http://www.annalsofepidemiology.org/article/S1047-2797%2896%2900123-8/abstract

Teicholz, N. (2014). The big fat surprise-Why butter, meat & cheese belong in a healthy diet. New York: Simon & Schuster. ISBM 978-1-4516-2442-7  http://www.thebigfatsurprise.com/

 


Don’t poison yourself: Avoid foods with high pesticide residues

Is it worth to pay $3.49 for the organic strawberries while the non-organics are a bargain at $2.49?

Are there foods I should avoid because they have high pesticide residues?

The United States Department of Agriculture (USDA) and the United States Environmental Protection Agency (EPA) state that pesticide residues left in or on food are safe and non-toxic and have no health consequences. I have my doubts! Human beings accumulate pesticides just like tuna fish accumulates mercury—frequent ingesting of very low levels of pesticides residue may result in long term harmful effects and these long term risks have not been assessed. Most pesticides are toxic chemicals and were developed to kill agricultural pests — living organisms. The actual risk for chronic low level exposure is probably unknown; since, the EPA pesticide residue limits are a political compromise between scientific findings and lobbying from agricultural and chemical industries (Portney, 1992).

Organic diets expose consumers to fewer pesticides associated with human disease (Forman et al, 2012).  In addition, preliminary studies have shown that GMO foods such as soy, potatoes, bananas and raisins reduces longevity, fertility and starvation tolerance in fruit flies (Chhabra et al, 2013)

Adopt the precautionary principle. As much as possible avoid the following foods that have high levels of residual pesticides as identified by the Environmental Working Group in their 2014 report.

Apples

Strawberries

Grapes

Celery

Peaches

Spinach

Sweet bell peppers

Nectarines-imported

Cucumbers

Cherry tomatoes

Snap peas-imported

Potatoes

Hot peppers

Blueberries-domestic

Lettuce

Kale/collard greens

For more details, see the Environmental Working Group report for the rankings of 48 foods listed from worst to best.

https://www.youtube.com/watch?feature=player_embedded&v=BfNQGd9BTK0

References:

Chhabra R, Kolli S, Bauer JH (2013) Organically Grown Food Provides Health Benefits to Drosophila melanogaster. PLoS ONE 8(1): e52988. doi:10.1371/journal.pone.0052988  http://www.plosone.org/article/info:doi%2F10.1371%2Fjournal.pone.0052988

Forman, J., Silverstein, J., Bhatia, J. J., Abrams, S. A., Corkins, M. R., de Ferranti, S. D., … & Wright, R. O. (2012). Organic foods: health and environmental advantages and disadvantages. Pediatrics, 130(5), e1406-e1415.

Portney, P. R. (1992). The determinants of pesticide regulation: A statistical analysis of EPA decision making. The Journal of Political Economy, 100(1), 175-197.

 


Concered about food and health?

If you are concerned about food and health, watch Michael Pollan’s presentation, How Cooking Can Change Your Life. It is pragmatic and full of wisdom.


From Wisdom to Alzheimer’s: Are we poisoning ourselves with affluent malnutrition and sedentary life style?

Wise elders, grand parents or statesmen have been the traditional roles for aging adults. Older people were revered as the repository and sources of wisdom in many traditional cultures.  Presently the development of aging into wisdom is being overshadowed by the specter of Alzheimer’s disease. Wisdom transforming into Alzheimer’s disease does not compute.  How come that in slightly more than a century after it was first described by the neuropathologist Alois Alzheimer in 1906, the fear of contracting and possible having Alzheimer’s disease with the concurrent  loss of cognitive and body functions is becoming a possibility? How could this have occurred?

Today more people are living to older ages; however, in traditional cultures some people also lived to very old age (the major increase in present day longevity is due to the elimination of infant and maternal mortality and medical treatment to survive trauma).

Is it possible that the prevention of Alzheimer’s will not be found in pharmaceutical treatment but in promoting organic food diet and movement?   The research data is starting to find that our life style patterns are risk factors for Alzheimer’s.  Changing lifestyle factors is a more promising treatment approach than drugs.  A significant risk factor may be the confluence of a sedentary lifestyle and affluent malnutrition. Researchers are even reporting that the built up of the beta amyloid plaques in brains of people with Alzheimer’s disease is not  the result of aging but the body’s attempt to cope with the influx of environmental and dietary poisons or decreases in essential foods or body activities.

Risk: Sedentary lifestyle-Too little exercise

Over the last hundred years–and rapidly accelerated in the last 30 years–we have transformed work into sitting. By sitting in front of a computer screen, we have created a new disease: Immobilization Syndrome. Lack of exercise is recognize as a major factor in numerous illnesses such as cardiovascular disease, obesity, and diabetes. Movement in many different forms reduces the risk of illness.  Older people who exercise have a significant reduction in the risk of developing Alzheimer’s  (Larson, 2006; Radak et al, 2010).

Regular movement lowers the risk. Even though there is overwhelming scientific evidence that movement and exercise are required for health, there is a disconnect with the medical and educational practices.  Insurances will pay for medical treatment; however, they usually will not pay for prevention or exercise.  At the same time physical education in schools is reduced or eliminated to reduce the risk of litigation (an injured child on the playground could sue the school).  Children now spend most of their time in front of a screen while exercising their thumb and index fingers instead of playing and moving outdoors.

Risk: Affluent malnutrition-too much sugar and simple carbohydrates

Affluent malnutrition appears to be another risk factor. Recent findings suggests that the beta amyloids plagues, as the marker for Alzheimer’s in the brain, may be a protective response to the modulating insulin levels triggered by affluent malnutrition and sedentary life style. This disease has been labeled as type 3 diabetes by Associate Professor Suzanne de la Monte at Brown University (Steen et al, 2005). Namely, the disease occurs as the brain tissue becomes resistant to insulin.

Rats that are fed high-fructose corn syrup laced water experienced learning and memory problems in less than 6 weeks and became less responsive to insulin.  At the same time if the animals were given omega 3 fatty acids, they appear to escape the cognitive decline.  In other research rats developed Alzheimer like brain changes and became demented when Suzanne de la Monte interfered with how the rats brains respond to insulin (Trivedi, 2012).

Alois Alzheimer first described these abnormal protein structure in the brains  a little more than a hundred years ago. At that time  the European diet had increased sugar intake as shown in figure 1. While more recently there has been a significant   increase in high fructose corn syrup as shown in figure 2.

Figure 1 sugar

Figure 1. Radical increase in sugar consumption in the last 200 years.  From: http://blog.zestos.co.nz/2010/09/sugar-consumption-been-high-before.html

Figure 2 High fructose corn syrup

Figure 2. Increase in the type of sugar consumption in the last thirty years.  From: http://blog.zestos.co.nz/2010/09/sugar-consumption-been-high-before.html

We are now becoming concerned with the Alzheimer’s disease as an upcoming epidemic.  It cannot be just sugar; since, its consumption has been high since the beginning of the 20th century. A possible contributor could be the high-fructose corn syrup; however, it is most likely the interaction between reduced exercise and sugar.

Sugar set the stage for pathogenesis to occur in the brain and the absence of movement/exercise promotes and supports the pathogenesis. People continue to decrease movement:  from walking or riding horses to sitting cars or standing on escalators and elevators; from doing physical housework to automated washing machines, driers and dishwashers; from preparing foods from raw materials to prepackaged foods; from filing and typing to computer work; from playing family games to watching TV and searching the net; from face to face communication to texting; etc.

We have separated from our biological evolutionary heritage.  I am not surprised that Alzheimer’s disease and immobility and sugar are linked.   Adopt the precautionary principle  and assume that sugar and high-fructose corn syrup in conjunction with reduced movement (immobilization syndrome) is  harmful.

As a reader, you will probably have to wait another 20 years before these findings have been scientifically proven against the overt and covert lobbying efforts of agribusiness and pharmaceutical industry.  Remember it took 30 years to demonstrate that smoking was harmful.  Begin to move and eat in concert with your evolutionary background (See Part III Self-care in Gorter and Peper, 2011).

Begin now!

Eat food not sugars! Eat the foods great grandparents would recognize as food as Michael Pollan (2009) describe in his superb book, In Defense of Food: An Eater’s Manifesto. Eat foods that have not been processed or adulterated by additives. Take charge by eating brain supporting foods such as organic vegetables, roots, fruits, nuts, fish, some organ meat, and eliminate all those sugary, fatty processed highly advertised fast foods.

Move and exercise!  Get up and move every hour. Walk up the stairs instead of the escalator. Meet new people and move by going  hiking,  dancing,  Tai Chi or yoga classes or volunteer by helping others.

References

Gorter, R. & Peper, E. (2011). Fighting Cancer-A Non Toxic Approach to Treatment. Berkeley: North Atlantic.

Larson, E.G., Wang, L., Bowen, J.D., McCormick, W. C., Teri, L., Crane, P., & Kukull, W. (2006).  Exercise Is Associated with Reduced Risk for Incident Dementia among Persons 65 Years of Age and Older. Ann Intern Med, 144(2), 73-81.

Pollan, M. (2009).  In Defense of Food: An Eater’s Manifesto. New York: Penguin Books.

Radak, Z., Hart. N., Sarga, L., Koltai, E., Atalay, M., Ohno, H., & Boldogh, I. (2010). Journal of Alzheimer’s Disease, 20(3), 777-83.

Steen, E., Terry, B.M.  Rivera, E.J., Cannon, J.L., Neely, T.R., Tavares, R., Xu, X. J., Wands, J.R., & de al Monte, S. M.  (2005). Impaired insulin and insulin-like growth factor expression and signaling mechanisms in Alzheimer’s disease-is this type 3 diabetes? Journal of Alzheimer’s Disease, 7(1), 53-80.

Trivedi, B. (2012). Eat your way to dementia. New Scientist, 215(2880), 32-37.


Live longer, enhance fertility and increase stress resistance: Eat organic foods

Health food advocates have long claimed that organic foods are better for your health because they have more nutrients and fewer pesticides than non organic or genetically modified grown foods.  On the other hand, the USDA and agribusiness tend to claim that organically grown foods have no additional benefits.  Until now, much of the published research appeared inconclusive and meta-analysis appeared to indicate that there are no health benefits from organic as compared to non organic foods although organic foods did reduce eczema in infants (Dangour et al, 2010).

Food studies that have demonstrated no benefits of organic farmed foods as compared to non-organic or genetically modified crops should be viewed with skepticism since many of these studies have been funded directly or indirectly by agribusiness. On the other hand, independently funded research studies have tended to demonstrate that organic foods are more beneficial than non-organic foods.  Sadly, the United States Department of Agriculture (USDA) and agribusiness are highly interdependent as the USDA both regulates and promotes agricultural products. On the one hand the USDA’s mission is “To expand economic opportunity through innovation, helping rural America to thrive; to promote agriculture production” and on the other hand “Enhance food safety by taking steps to reduce the prevalence of food borne hazards from farm to table, improving nutrition and health by providing food assistance and nutrition education and promotion.  (For more discussion on the conflict of interest between agribusiness and the USDA, see Michael Pollan’s superb books, The Omnivore’s Dilemma: A Natural History of Four Meals and In Defense of Food: An Eater’s Manifest).

Historically, most nutritional studies have investigated the nutritional difference or pesticide residue between organic and non-organically farmed.  Many studies have shown that organic grown foods have significantly lower pesticide residues than non organic foods (Baker et al, 2002; Luc, 2006). Even though agribusiness and the USDA tend to state that the pesticide residues left in or on the food are safe and non-toxic and have no health consequences, I have my doubts. Human beings accumulate pesticides just like tuna fish accumulates mercury—frequent ingesting of very low levels of pesticides residue may result in long term harmful effects. One way to measure if there is an effect of organic, non organic or genetically modified grown foods or residual pesticides is to do a long term follow up and measure the impact over the lifespan of the organism.   This is difficult with human beings; since, it would take 50 or more years to observe the long term effects. Nevertheless, the effects of organically grown foods versus non-organically grown foods upon lifespan, fertility and stress resistance  has now been demonstrated with fruit flies.

The elegant research by Chhabra R, Kolli S, Bauer JH (2013) showed that when fruit flies were fed either organic bananas, potatoes, soy or raisins, they demonstrated a significant increase in longevity, fertility and stress resistance  as compared to eating non-organic bananas, potatoes, soy and raisins.  In this controlled study, the outcome data is stunning.  Below are some of their results reproduced from their article, “Organically Grown Food Provides Health Benefits to Drosophila melanogaster.”

Slide1

Figure 1. Longevity of D. melanogaster fed organic diets. Survivorship curves of female fruit flies fed diets made from extracts of potatoes, raisins, bananas or soybeans (grey: conventional food; black: organic food; statistically significant changes (p,0.005) are indicated by asterisks).Median survival times of flies on conventional and organics food sources, respectively, are: potatoes: 16 and 22 days (,38% longevity increase,p,0.0001); soybeans: 8 and 14 days (,75% longevity increase, p,0.0001).doi:10.1371/journal.pone.0052988.g001. Reproduced from Chhabra R, Kolli S, Bauer JH (2013).

Slide2

Figure 2. Daily egg-laying of flies exposed to organic diets. Egg production of flies fed the indicated food was determined daily. Shown are the averages of biological replicates; error bars represent the standard deviation (grey: conventional food; black: organic food; statistically significant changes (p,0.005) are indicated by asterisks; p,0.0001 for all food types). doi:10.1371/journal.pone.0052988.g002. Reproduced from Chhabra R, Kolli S, Bauer JH (2013).

Slide3

Figure 3. Starvation tolerance of flies raised on organic diets. Survivorship curves of female flies raised for 10 days on the indicated food sources. Flies were then transferred to starvation media and dead flies were counted twice daily (grey: conventional food; black: organic food; statistically significant changes (p,0.005) are indicated by asterisks). Median survival times of flies on conventional and organics food sources, respectively, are: potatoes: 6 and 24 hours (p,0.0001); bananas: 24 and 48 hours (p,0.0001). doi:10.1371/journal.pone.0052988.g003. Reproduced from Chhabra R, Kolli S, Bauer JH (2013)

This elegant study demonstrated the cumulative impact of organic versus non-organic food source upon survival fitness.  It demonstrated that non-organic foods decreased the overall health of the organism which may be due to the lower levels of essential nutrients, presence of pesticides or genetic modified factors.

The take home message of their research is: If you are concerned about your health, want to live healthier and longer, improve fertility and resist stress, eat organically grown fruits and vegetable. Although this research was done with fruit flies and human beings are not fruit flies since we eat omnivorously, it may still be very relevant especially for children.  As children grow the ingestion of non-organic foods may cause a very low level nutrient malnutrition coupled with an increased exposure to pesticides.  The same concept can be extended to meats and fish. Eat only meat from free ranging animals that have been fed organic grown foods and not been given antibiotics or hormones to promote growth.

Bon appétit 

.References

Baker, B.P., Benbrook, C.M., & Groth III, E., & Lutz, K. (2002). Pesticide residues in conventional, integrated pest management (IPM)-grown and organic foods: insights from three US data sets. Food Additives and Contaminants, 19(5)  http://www.tandfonline.com/doi/abs/10.1080/02652030110113799

Chhabra R, Kolli S, Bauer JH (2013) Organically Grown Food Provides Health Benefits to Drosophila melanogaster. PLoS ONE 8(1): e52988. doi:10.1371/journal.pone.0052988  http://www.plosone.org/article/info:doi%2F10.1371%2Fjournal.pone.0052988

Dangour, A.D., Lock, K., Hayter, A., Aikenhead, A., Allen, E., Uauy, R. (2010). Nutrition related health effects of organic foods: a systematic review. Am J Clin Nutr, 92,203–210.  http://ajcn.nutrition.org/content/92/1/203.short

Luc, C., Toepel, K., Irish, R., Fenske, R.A., Barr, D.B., & Bravo, R. (2006). Organic Diets Significantly Lower Children’s Dietary Exposure to Organophosphorus Pesticides. Environ Health Perspect, 114(2), 260–263. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1367841/

Pollan, M. (2009). In Defense of Food: An Eater’s Manifesto. New York: Penguin Press. ISBN: 978-0143114963

Pollan, M. (2006). The Omnivore’s Dilemma: A Natural History of Four Meals. New York: Penguin Press. ISBN: 1594200823


Epilepsy: New (old) treatment without drugs

Nothing is so hard as watching a child having a seizure.

           –Elizabeth A. Thiele, MD, PhD, professor of neurology at Harvard Medical School

Until recently, when people asked me, “What would I suggest as a non-toxic/non-invasive biofeedback approach for the treatment of epilepsy?” I automatically replied, “A combination of neurofeedback, behavioral analysis treatment, respiration training, a low glycemic diet, and stress management and if these did not work, medications.” I have now changed my mind!

Epilepsy is diagnosed if the person has two or more seizures. About one to two percent of the population is diagnosed with epilepsy and it is the most common neurological illness in children. Medication is usually the initial treatment intervention; however, in about one third of the people, the seizures will still occur despite the medications. In some cases, people -often without the support of their neurologist/healthcare provider–will explore other treatment strategies such as diet, respiration training, neurofeedback, behavioral control, diet, or traditional Chinese medicine.

It is ironic that one of the tools to diagnose epilepsy is recording the electroencephalography (EEG)– brain waves–of the person after fasting while breathing quickly (hyperventilating). For some, the combination of low blood sugar and hyperventilation will evoke epileptic wave forms in their EEG and can trigger  seizures (hyperventilation when paired with low sugar levels tends to increase slow wave EEG which would promote seizure activity).
If hyperventilation and fluctuating blood sugar levels are contributing factors in triggering seizures, why not teach breathing control and diet control as the first non-toxic clinical intervention before medications are prescribed. This breathing approach has shown very promising clinical success.  (For more details  see the book, Fried, R. (1987). The Hyperventilation syndrome-Research and Clinical Treatment. Baltimore: The Johns Hopkins University Press).

Self-management should be the first clinical intervention and not the last. Similarly, neurofeedback– brain wave biofeedback–is another proven approach to reduce seizures. This approach was developed by Professor Maurice B. Sterman at UCLA and was based upon animal studies. He demonstrated that cats who were trained to increase sensory motor rhythm (SMR) in their EEG  could postpone seizure onset when exposed to a neurotoxin that induced seizures. He then demonstrated that human beings with epilepsy could equally learn to control their EEG patterns and inhibit seizures. This approach, just as the breathing approach, is non-toxic and reduces seizures.

Underlying both these approaches is the concept of behavioral analysis to identify and interrupt the  chained behavior that leads to a seizure. Namely, a stimulus (internal or external) triggers a cascading chain of neurological processes that eventually results in a seizure. Thus, if the person learns to identify and interrupt/divert this cascading chain, the seizure does not occur. From this perspective, respiration training and neurofeedback could be interpreted to interrupt this cascading process. Behavioral analyses includes all behaviors (movement, facial expressions, emotions, etc) which can be identified and then interrupted. As professors Joanne Dahl and Tobias Lundgren from Uppsala University in Sweden state, The behavior technology of seizure control provides low-cost, drug free treatment alternative for individual already suffering from seizures and the stigmatization of epilepsy.

Until recently, I would automatically suggest that people explore these self-control strategies as the first intervention in treatment of epilepsy and only medication for the last resort. Now, I have changed my mind. I suggest the ketogenic diet as the first step for the treatment of epilepsy in conjunction with the self-regulation strategies—medication should only be used if the previous strategies were unsuccessful.

A ketogenic diet  has a 90% clinical success rates  in children–even in patients with refractory seizures. This diet stabilizes blood sugar levels  and is very low on simple carbohydrates, high in fat,  some protein, and lots of vegetables (a ratio of 4 grams of fat to 1 gram of carbohydrates and protein). In adults, the success rates drops to about 50%. The lower success rate may be the result of   the challenges in implementing these self-regulatory diet approaches. As Elizabeth A. Thiele, MD, PhD, professor of neurology at Harvard Medical School points out, dietary therapy is the most effective known treatment strategy for epilepsy. Even though, ketogenic diet is the most effective therapy, it is less likely to be prescribed than medications—there are no financial incentives; there are, however, many financial incentives for prescribing pharmaceuticals.

These lifestyle changes are very challenging to implement. They need to be taught and socially supported. Just telling people what to do does not often work. It is similar to learning to play a musical instrument.  The person needs step by step coaching and social support which is an intensive educational approach. To learn more about the research underlying the ketogenic diet as the first level of intervention for epilepsy, watch Professor Thiele’s presentation from the 2012 Ancentral Health Symposium, Dietary Therapy: Role in Epilepsy and Beyond.


Cut out the sugar-it is toxic!

Putting it simply: Too much sugar in our diet is harmful and when we return to our paleolithic diet, health tends to improve.

Sugar intake in all different forms is the single most important ingredient that contributes to diabetes. In the last one hundred years our sugar intake has radically increased as is shown in figure 1.

sugars a

Figure 1. Sugar intake per capita in the United Kingdom from 1700 to 1978 and in the United states from 1975-2000. The line on the right with black dots is the obesity rates in the United States in non-Hispanic white men aged 60-69 y. Values for 1880-1910 are based on studies conducted in male Civil War veterans aged 50-59y. From: Johnson RJ et al, AJCN 2007; 86:899-906;  Initial source: http://www.indiana.edu/~oso/Fructose/Fructose.html

Even though research and clinical findings over the last one hundred years have shown that increased sugar and processed simple carbohydrate  intake are contributing factors to many illnesses ranging from diabetes, obesity, cancer and even epilepsy, the data is now undisputable.  As Mark Bittman wrote in the New York Times on February 27th, “Sugar is indeed toxic. It may not be the only problem with the Standard American Diet, but it’s fast becoming clear that it’s the major one.” 

When  researchers accounted for poverty, aging, exercise, total food intake, and other factors, increased sugar intake increased diabetes and decreased sugar decreased diabetes.  As the authors state, “for every 150 kcal/person/day increase in sugar availability (about one can of soda/day) there was associated with increased diabetes prevalence by 1.1% (p <0.001).”  (Basu S, Yoffe P, Hills N, Lustig RH (2013) The Relationship of Sugar to Population-Level Diabetes Prevalence: An Econometric Analysis of Repeated Cross-Sectional Data. PLoS ONE 8(2): e57873. doi:10.1371/journal.pone.0057873)

Presently, the level of proof linking sugar to diabetes is equal to if not better than the level of proof that linked cigarette smoking to lung cancer and other illnesses. Despite the overwhelming scientific data, it will be an uphill battle to change our diet and diet recommendations from the highly processed high glycemic index diet that promotes inflammation and diabetes to a low glycemic index Paleolithic diet that supports health. The major agricultural and food processing businesses have significant influence with the USA Government (for Senate and House members lobbying pays for the election), the  FDA and USDA priorities are also highly affected through direct and indirect lobbying efforts or by the financial reward to be offered a job in the agribusiness after working for the FDA or USDA.  In the USA lobbying and being rewarded with a highly paid job in industry is the expression of the democratic process–for the rest of the world it is called bribery.  Thus, it is likely that agricultural and food processing industries will continue to delay and obstruct any recommendations to reduce sugars and highly processed carbohydrates in our food supply. A preview of this battle has already occurred when Major Michael Bloomberg of New York City intended to restrict sales of sugary soft drinks to no more than 16 ounces a cup in city restaurants, movie theaters, stadiums and arenas. A barrage of negative comments filled the media spaces. For example,  Bloomberg News,  reported  the comments by Kirsten Witt Webb, a Coca-Cola (KO) spokeswoman, who said  in an e-mail. “They can make their own choices about the beverages they purchase. We hope New Yorkers loudly voice their disapproval about this arbitrary mandate.”   

Soft drinks and soft drinks contain often eight or more table spoons of sugar per drink as shown in Figure 2.

coca cola and sugarFigure 2. Amount of sugar cubes in soft drinks. Source: http://www.sugarstacks.com/beverages.htm

The sugar/highly processed foods battle will be similar to the battle the smoking lobby fought for the last 30 years. Just like tobacco subsidies, farmers receive subsidies to grow corn to make more low cost high fructose corn syrup. As recent as 2005 tobacco farmers were still receiving  a billion and a half dollars in subsidy while farmers growing corn received more than seven billion dollars in subsidies as shown in Figure 3.

corn subsidy

Figure 3. Farm subsidies in 2005. source: http://en.wikipedia.org/wiki/Agricultural_subsidy

At the same time pharmaceutical companies continue to reap a financial bonanza from the sugar diet induced illnesses. They will create more and more drugs to attempt to reduce the illnesses and symptoms.

We cannot expect the US government to promote our health as the lobbying power by agribusiness is overwhelming. We cannot expect published information, whether on the web or in print, to be accurate as advertising dollars significantly affect editorial decisions.

We can start eating differently ourselves and with our families and friends. Begin now. Do an experiment by eating a predominantly Paleolithic diet. For the next two weeks, eat only foods that are real foods which your great grandparents recognized as food. Thus nothing out of box or can. Nothing that has been processed or prepared!  Buy only foods in their natural form. Shop at  farmers’ markets or only at the periphery of the supermarket: vegetables and fruits, the meat and fish counters. After eating this diet  for two weeks, check how you feel.  Many people report having more energy, feeling less tired and irritability,  and  some experience a reduction in arthritic pains, inflammation, headaches and even anxiety.  For dietary suggestions see the common sense recommendations in Michael Pollan’s book, In Defense of Food: An Eater’s Manifesto.