Nina’s plea: Would you write to Congress and change USA food guidelines?

This is a message from Nina Teicholz, writer and low carb activist:

My highest concern about the existing USA Food Guidelines is for the people who have no choice but to eat the food that they are given, which is based on what is thought of as “a healthy diet”. There are many essentially ‘captive’ populations in schools, hospitals, and prisons. Many of these people are the most disadvantaged among us. Native Americans on reservations have no choice about the food assistance they receive.

I’ve spoken with the Native American woman who for years has been trying to change the USDA food they get, and she cannot get even the tiniest change. They desperately need the food, yet it’s more than 50% carbs, and something like 40% of the kids on these reservations have diabetes.

The same is true for poor people, education programs, and feeding programs for the elderly. These people have no choice.  No other food  is given to them. Many doctors also say they have no choice, because  they are required to teach the guidelines to patients. It is the same thing in most federally funded institutions.

Thus, my hope is, if we have to have Guidelines for the time being, that they do as little harm as possible. The Guideline is coming up for review, but the committee have already decided not to review the evidence on low carb diet studies.  We are seeking to change this, and there is already some support for our position, that these studies should be included in the evaluation. Could we get in a low-carb option? Could we force them to consider all the science on saturated fats? This next set of Guidelines will come out by the end of this year, and I think there is still time to try to force change. Our actions now would build awareness around the issue that there is something wrong with the Guidelines. There is so little awareness of the problems. And actually I’m hopeful,  because in the last few months, we’ve worked with a number of groups to raise awareness to a level it’s never been before.

Here’s what I would suggest for now.
Both my group, The Nutrition Coalition and the group Low-carb Action Network,  have webpages that make it very easy for you (if American) to write/call your Members of Congress. This is super important and I urge everyone to do this. USDA is not budging. Congress is really the only body of power interested in change, and they need to hear from people. So I would urge everyone to contact their members of Congress. It can take just a few min.

Thank you,

Nina

My comment: If the USDA food guidelines are changed, it would make it so much easier for the UK to follow. The photograph shows the breakfast given to a diabetic patient in a US hospital who had just had a heart attack. The UK also dishes out abysmal food to its patients. Wouldn’t it be great if they had a low carb option?

Paleo Canteen recipe book

Ally and John are Scottish chefs who have a van in Glasgow from which they sell reasonably priced, interesting, low carb fare.

Paleo canteen recipe

They are releasing their first recipe book in the next few weeks and you can get  a sample version of the book  here:

bit.ly/cooklowcarb

paleo canteen

They both have extensive educational backgrounds, having both studied for PhDs before leaving physics and philosophy behind them,  to take up chef’s whites and knives.  Both have worked across a range of cooking genres at excellent restaurants such as Ottolenghi’s in London  and Rogano’s in Glasgow.

Their full book includes meat, particularly moderately priced meats, poultry and fish, vegetables, soups, salads, sauces and desserts. They are aware that low carbing has a reputation for being pricey and they want to make delicious meals with the five star touch accessible to all.

 

 

 

Belinda Fettke: The origins of the food companies behind the grain based diet

This is part one of a three part series on how we have ended up with a cardiovascular disease epidemic, what treatments we are using which don’t work, and what treatments do work.

The in first episode Belinda Fettke discusses the history behind the 7th Day Adventists who genuinely believed that they were bringing health to the USA population by promoting a grain based diet.

This is a long video but entertaining as well as informative.

 

Dr Maryanne Demasi: What does “low GI” really mean?

The Low GI Label: sound science or a ploy for product promotion?
Mar 5, 2019 | Business, Comment Analysis

Is it ethical to promote the health benefits of “low GI” labelling? How about multinational food companies paying to have their products certified? At best, it provides little value to the consumer, writes science journalist Dr Maryanne Demasi, At worst, the low GI symbol is misleading and should pass the way of the Heart Foundation tick.
FOR DECADES, “low GI” foods have received the backing of high profile scientists and nutritionists, promoting them as the “healthier choice”.
A lucrative industry has evolved whereby food companies pay to showcase the low GI symbol on the front of product packaging, much like the now defunct Heart Foundation tick.
Recipe books, weight loss programs and nutrition health messages are often bound to the notion that low GI foods are “better for you”. But a closer examination of the science exposes fundamental flaws that threaten the credibility of the low GI industry. What is low GI and are consumers being misled?
What is Low GI?
According to the Glycaemic Index (GI) Foundation, the “GI” of food is simply a ranking of how quickly various foods cause a spike in your blood sugar levels.
The entire concept was based on the results of only 10 healthy subjects who ingested carbohydrate-laden foods and the effect on their blood sugar levels was assessed.
The GI scale ranges from zero to 100. A GI of ≤55 is classified as “low GI” because it causes a slower rise in blood glucose compared to “high GI” (see graph)

Does GI work in practice?
On the surface, the GI concept makes sense.
That is, the low GI symbol should guide consumers to choose products that will not spike their blood sugar levels too high, which is especially important for people with diabetes.
Except, the science doesn’t back it up.
Researchers have put it to the test and determined that the GI of food cannot predict, with any accuracy or precision, the way a person’s blood glucose will respond.
For example, when 63 healthy subjects ingested an identical meal of white bread in order to calculate its GI (based on the protocol), the results were highly variable. The range of individual responses to white bread saw GI calculations as low as 35 whereas others were as high as 103.
With such a large margin of error, the researchers concluded that there was “substantial variability in individual responses to GI, demonstrating that it is unlikely to be a good approach to guiding food choices.”
Registered nutritionist Anthony Power says these results demonstrate the futility of labeling products with the low GI symbol.
“The method for ranking the GI of food might work well in a test-tube but it does not translate to the human body,” says Power. “The variability in people’s response to GI does not make the tool useful”.
Prof Eugene Fine, a physician from at Albert Einstein College of Medicine, NY says “the whole point of the GI, is supposed to be its usefulness in predicting blood sugar levels. But since studies show such a broad scatter plot, it’s clinically useless”.
Prof Mary Gannon, nutrition researcher from the University of Minnesota, agrees.
“In our opinion, the clinical relevance is minimal. The reliability of the GI as a standardized index of food response is questionable,” says Gannon.
Another fundamental flaw in the GI labeling of food is that various situations will alter the GI properties of food once its ingested.
For example, the GI of a slice of bread will change if it is accompanied with butter or avocado, rendering the GI label redundant.
In defence of GI
Professor Jennie Brand-Miller, nutrition researcher and early pioneer of the GI concept, has defended the criticisms, although she does concede that low GI foods have variable results in people.
“It’s been known for a long time that glycaemic responses are highly variable between, and within, individuals,” says Brand-Miller in a written response. “But the Glycaemic Index is a property of the food – not the person – determined by testing 10 people according to a precise protocol of over 300 data points”.
Prof Brand-Miller adds, “The GI ranks foods according to their glycemic potential, gram-for-gram of carbohydrate.”
However, Richard Feinman, professor of biochemistry and medical researcher from SUNY Downstate Medical Center NY, says there’s no point assigning an index to food, if it doesn’t have any relevance in the human body.
“The studies demonstrate that there is no ‘true’ GI for any food that reliably predicts a person’s blood glucose,” says Feinman.
Prof Brand-Miller, who promotes the benefits of low GI foods, did disclose that she receives royalties from co-authoring low GI books along with other high profile nutritionists.
According to the University of Sydney, Prof Brand-Miller’s book sales “have gained her international acclaim, having sold over 3.5 million copies since 1996”.

GI for people with diabetes
Originally, the GI label was intended as a tool for meal planning for people with diabetes. Prof Brand-Miller says low GI diets have been shown to reduce blood glucose levels in people with diabetes.
“A large body of research shows that diets based on healthy low GI choices improve glycemic control in people with diabetes, and reduce the risk of developing diabetes in healthy populations,” says Brand-Miller.
However, Associate Professor Kieron Rooney, exercise and obesity researcher from the University of Sydney suggests that the GI ranking of food is likely to have very different outcomes in people with diabetes.
“It is possible that most products would be high GI for a person with diabetes by nature of the underlying disease,” says Rooney referring to the inability of people with diabetes to naturally control blood sugar levels.
Even if low GI food reduces the spike in blood sugar, the total “load” of glucose entering the blood stream still has to be processed, which requires substantial amounts of the hormone insulin. Symptoms from high insulin levels include food cravings, fatigue and weight gain.
Prof Gannon suggests a more practical alternative to focusing on the low GI diet. “A more clinically relevant approach for dietary treatment of high blood sugar would be to limit dietary glucose,” says Gannon.
Put simply, people should eat less starchy carbohydrates, which get converted into glucose once ingested.
Professor Feinman agrees. His recent study demonstrated that restricting dietary carbohydrates should be the first approach to managing diabetes, over the low GI diet.
In addition, Professor Eric Westman and colleagues at Duke University Medical Centre NC, conducted a study in people with type-2 diabetes and showed that restricting dietary carbs led to greater improvements in blood sugar control and reduction/elimination of medications, compared to the low GI diet.
A marketing ruse?
GI is focused on “glucose” and overlooks other sugars like fructose, which is often added to sweeten foods in the form of refined cane sugar, corn syrup or fruit concentrates.
“The standard methodology for assessing GI is to utilise a glucose drink as the reference food,” says Rooney, “but the most common sugars added to products will contain significant levels of fructose. Therefore, if one is only measuring blood glucose response to a food you are missing out on a lot of the story.”
Fructose has a low GI (doesn’t spike blood glucose levels). Therefore, food manufacturers have been able to exploit this loophole.
Products can be sweetened with concentrates containing fructose and rewarded with a low GI symbol, essentially giving a “healthy halo” to highly processed sugary foods.
For example, low GI foods include Golden North Good ‘n Creamy Vanilla ice cream GI = 31, Sanitarium™ Up & Go™ Chocolate drink GI = 28 or Nestlé® Milo® Energy Dairy Snack GI = 45.

Even pure table sugar is marketed with the low GI symbol, CSR LoGICaneTM, claiming that it’s a “healthier” sugar.
“I am not convinced that by consuming a lower GI form of another refined sugar product, the health of an individual will be improved,” says Rooney.
“We need to shift away from a culture of adding refined sugars and seek enhancing the palatability of our diets by consumption of natural unrefined/minimally processed foods,” says Rooney. “In any policy that hopes to inform people on foods and drinks to maintain or improve glycaemic control, I think fructose has to be considered.”
Chronically high levels of fructose have been associated with fatty liver disease and diabetes.
When asked whether fructose sweetened drinks like Sanitarium™ Up & Go™ Chocolate drink were considered “healthy” because of their low GI symbols, Prof Brand Miller declined to comment.
“Just because a product is low GI, it does not mean it hasn’t got a sting in its tail,” says Power. “As a practitioner who counsels patients to reduce their sugar, sweetener and carbohydrate intake, I find products like Low GI sugar to be unhelpful, misleading and possibly harmful to patients. It should not be allowed.”
Who supports GI?
Despite Prof Brand-Miller’s defence of GI, official guidelines do not endorse low GI diets.
For example, Health Canada has stated that “the inclusion of the GI value on the label of eligible food products would be misleading and would not add value to nutrition labelling and dietary guidelines in assisting consumers to make healthier food choices.”
In response to the question of whether low GI foods are healthier, UK’s National Health Service (NHS) states
“using the glycaemic index to decide whether foods or combinations of foods are healthy can be misleading”.
Closer to home, our National Health and Medical Research Council (NHMRC) dietary guideline’s committee, also does not officially endorse the low GI diet. And despite the GI Foundation lobbying the NHMRC to change its mind, the response was a direct one;
“The Committee agreed that there was insufficient significant evidence to support change. It was noted that this is a physiologically based classification, with large variability and several limitations.”
Meanwhile, the GI Foundation, the University of Sydney and its high profile advocates continue to profit from the marketing of low GI foods.
Will the “Low GI symbol” suffer the same fate as the “Heart Foundation Tick” which was scrapped after consumers complained it was “health washing” highly processed, sugary foods?
What remains now, is a question of ethics.
Is it ethical to promote the health benefits of low GI labelling? At best, it provides little value to the consumer. At worst, it misleads them.
——————–

Dr Maryanne Demasi
Dr Maryanne Demasi is an investigative medical reporter with a PhD in Rheumatology.
You can read more about Dr Demasi’s work on her blog, or follow her on Twitter @MaryanneDemasi.

Kris Kresser: Everything you need to know about a ketogenic diet

A Complete Guide to the Keto Diet
by Chris Kresser
Published on April 2, 2019
Ketogenic diets are currently all the rage. Seemingly every health personality has an opinion on the ketogenic diet, commonly referred to as “keto.” Some tout it as a cure-all for everything from diabetes to cancer, while others express skepticism or disagree with some aspects of the diet.

The keto diet could help alleviate conditions like obesity and type 2 diabetes and even impact the progression of some types of cancer, but it isn’t for everyone.

It’s understandable that you may be wondering how to sort out the facts and interpret the latest research. Who is a good candidate for keto, and who should avoid it? How does someone successfully adhere to a ketogenic diet? In this article, I’ll answer these important questions and others so you can make an educated decision about whether keto is right for you.

What is the keto diet?
Nine conditions that respond well to keto
Who should avoid the diet
The keto time frame
Three steps to starting keto
13 tips and tricks
What to expect on keto
What Is the Keto Diet?
The ketogenic diet is a high-fat, moderate-protein, low-carb food plan. The typical macronutrient ratios are 60 to 75 percent of calories from fat, 15 to 30 percent of calories from protein, and 5 to 10 percent of calories from carbohydrates.
By strictly limiting dietary carbohydrates, the ketogenic diet encourages the body to switch from using glucose as a primary fuel source to burning body fat and using ketones for fuel. This metabolic switch has a variety of beneficial effects on the body, ranging from fat loss to improved brain function.
The keto diet could potentially address a number of health conditions, such as obesity, type 2 diabetes, and even cancer. Check out this article for more information on who should try keto—and who shouldn’t—and get tips to help you. #lowcarb #nutrition #chriskresser

A ketogenic diet differs dramatically from the carbohydrate-heavy Standard American Diet. When you eat a carbohydrate-rich meal, the ingested carbs are broken down into glucose. Glucose is then shuttled into cells by insulin, where it is used for energy production. The constant consumption of a high-carbohydrate diet causes the body to rely on glucose (sugar) for fuel, while rarely tapping into fat stores for energy. A ketogenic diet does just the opposite. It forces the body to turn to fats for fuel. A keto diet encourages the production of ketones, small water-soluble compounds, and the “burning” of fatty acids in adipose tissue (fat cells) for energy. Ketones are unique in that they are rapidly taken up by tissues and broken down to yield ATP, the primary energy currency of the human body. The process by which the body switches to using ketones for energy is referred to as “nutritional ketosis,” while the process of tapping into your body’s fat stores is termed “fat adaptation.”

Choosing the right diet can be a difficult process of trial and error. Health coaches support people in finding the best diet for their bodies, lifestyles, families—wherever they need encouragement in discovering the right path, etc. As a coach, you learn to ask the questions that help people figure out whether a diet is the right fit for them. This not only helps them make a good choice but minimizes the time they spend with diets that don’t work well for them.

Health coaches can also help people navigate their chosen diets, like the ketogenic diet. As an example, some people may need a little extra push getting their bodies to transition to using ketones. If you are finding it difficult to get into ketosis, a health coach can help you navigate that process.
How do health coaches do this? In our ADAPT Health Coach Training Program, you learn about a variety of diets—including the ketogenic diet—how they work, who they work well for, and how to support people in making diet transitions. Visit our health coach training program page to find out more.

The ADAPT Health Coach Training Program is an Approved Health and Wellness Coach Training & Education Program by the National Board for Health and Wellness Coaching (NBHWC).
Nine Conditions That Are Ideal for Keto
The ketogenic diet offers many health benefits, but it isn’t right for everyone. Read on to learn who stands to benefit the most from keto and which conditions tend to respond the best to the diet.
1. Obesity
Disturbing statistics indicate that weight problems have reached epidemic proportions in the United States, with nearly 72 percent of American adults 20 and over categorized as overweight or obese. (1) The mandate that overweight and obese individuals should merely “eat less and exercise more” is failing miserably; it does little to correct the underlying metabolic disturbances driving obesity, trapping people in a vicious cycle of weight loss and regain. However, all hope is not lost! The ketogenic diet is emerging as a powerful, sustainable tool for weight loss in overweight and obese individuals.
A growing body of research indicates that ketogenic diets are more effective than low-fat diets for sustaining long-term weight loss in obese adults. (2, 3) Furthermore, the weight loss observed on a ketogenic diet is primarily visceral fat, the hard-to-lose fat located deep in the abdominal cavity; lean body mass, on the other hand, is preserved. (4)
A ketogenic diet may also benefit obese children. A study that placed obese children on a ketogenic diet for six months observed significant decreases in body fat, waist circumference, fasting insulin levels, and HOMA-IR, a marker used to detect insulin resistance. (5)
The ketogenic diet facilitates fat loss by increasing the efficiency of fat oxidation (the process by which fat is “burned” for energy), suppressing hunger hormones, and providing the body with plenty of satiating dietary fat and protein, thus decreasing total energy intake. (6)
For those who do not wish to stay on the ketogenic diet long term, a cyclic ketogenic diet alternated with a nutrient-dense, whole foods diet can also lead to successful long-term weight loss. (7) I’ll cover the cyclic ketogenic diet in more depth shortly.
2. Metabolic Syndrome
Over one-third of Americans have metabolic syndrome, a constellation of complications including increased blood pressure, elevated blood sugar, excess abdominal fat, and abnormal triglyceride and cholesterol levels that significantly increase one’s risk of heart disease, diabetes, and stroke. (8) The conventional treatment of metabolic syndrome typically involves cholesterol-, blood sugar-, and blood pressure-lowering medications, along with vague advice to “eat better.” Given that heart disease is still the number one cause of death in the United States, that diabetes is considered to be at epidemic proportions, and that strokes disable or kill someone every 40 seconds on average, this treatment paradigm leaves much to be desired. (9)
Fortunately, patients have an alternative—a ketogenic diet. Research indicates that a ketogenic diet improves multiple aspects of metabolic syndrome, inducing significant reductions in body fat percentage, BMI, hemoglobin A1c levels, blood lipids, and blood pressure. (10, 11, 12) The ketogenic diet produces these beneficial effects by reversing the pathological processes underlying metabolic syndrome, including insulin resistance and chronic inflammation.
3. Type 2 Diabetes
Ketogenic diets represent a far more effective strategy for managing type 2 diabetes than the American Diabetes Association’s high-carb, low-fat dietary guidelines. Unlike the ADA’s guidelines, a ketogenic diet significantly reduces blood sugar, hemoglobin A1c levels, waist circumference, and triglycerides in diabetic individuals. (13) Most importantly, research indicates that the diet is sustainable for diabetic patients and that the beneficial changes can be maintained over the long term. (14)
4. Polycystic Ovary Syndrome (PCOS)
Between 5 and 10 percent of women in the United States have polycystic ovary syndrome (PCOS), a disorder characterized by insulin resistance, menstrual irregularities, hyperandrogenism, overweight, and obesity. (15) A ketogenic diet improves fertility in women with PCOS by improving insulin resistance, promoting weight loss, and inducing ovulation. (16)
5. Neurodegenerative Diseases
A great deal of exciting research is emerging regarding the application of a ketogenic diet in the treatment of neurodegenerative diseases, including Alzheimer’s and Parkinson’s disease. (17) Neurodegenerative diseases are characterized by brain insulin resistance, a condition that starves neurons of the glucose they normally need to function correctly. Scientists have found that ketones are an excellent alternative fuel for the insulin-resistant brain. In addition, ketones reduce brain oxidative stress and mitochondrial dysfunction, two significant factors in the neurodegenerative disease process.
Animal research indicates that a ketogenic diet reduces levels of brain amyloid-beta, a misfolded protein that contributes to Alzheimer’s disease, while also restoring mitochondrial function and improving learning and memory. (18, 19, 20) Although fewer studies on a ketogenic diet have been done in humans with Alzheimer’s disease, a recent trial found a ketogenic diet to be both safe and effective for mild Alzheimer’s disease. (21)
Preclinical research suggests that a ketogenic diet may also benefit those with Parkinson’s disease. In animal models of Parkinson’s, a ketogenic diet improves motor function, and in humans with Parkinson’s, it improves nonmotor symptoms such as daytime sleepiness and cognitive disorders. (22, 23) While more research is needed, a ketogenic diet may be a powerful intervention well worth a try for both Alzheimer’s and Parkinson’s patients.
6. Traumatic Brain Injury and Epilepsy
Traumatic brain injury (TBI) is an injury caused by a blow, bump, or jolt to the head that significantly impairs brain function. TBI is common in military personnel, car accident survivors, and athletes involved in contact or high-risk sports. If left untreated, TBI can cause severe impairments in thinking, memory, and emotional regulation. Interestingly, a ketogenic diet may be an effective strategy for reducing the harmful effects of TBI.
A ketogenic diet promotes healing of the brain following TBI by increasing the activity of genes genes involved in energy metabolism, stimulating the generation of new mitochondria, and inhibiting the production of damaging reactive oxygen species in the brain. (24) In animal models of TBI, a ketogenic diet reduces cerebral edema and neuronal cell death while improving behavioral outcomes. (25, 26) While individual success stories of people using a ketogenic diet for TBI are easy to find on the internet, formal clinical trials are still needed.
Compared to TBI, the amount of scientific literature documenting the beneficial effects of a ketogenic diet for epilepsy is vast. The ketogenic diet was first introduced as a therapy in the 1920s, when doctors learned it could successfully treat seizures in children with refractory epilepsy. (27) Interest in the ketogenic diet waned when antiepileptic drugs were introduced in the 1960s and ’70s; however, the ketogenic diet has experienced a recent resurgence in popularity in the epilepsy community, particularly among those suffering from drug-resistant epilepsy.
The ketogenic diet exerts antiepileptic effects by improving energy metabolism in the brain and reducing brain oxidative stress. Fascinating new research suggests that the antiseizure effects of the ketogenic diet are also mediated by modulation of the gut microbiota. (28) Consumption of a ketogenic diet increases the levels of bacteria that produce GABA, the brain’s primary inhibitory neurotransmitter; this shifts neurotransmission towards inhibition rather than excitation, thus preventing neuronal hyperexcitability and seizure onset.
7. Digestive Disorders
A high carbohydrate intake can exacerbate irritable bowel syndrome (IBS) and gastroesophageal reflux disease (GERD) by feeding opportunistic and pathogenic bacteria in the gut. (29) These microbes ferment dietary carbohydrates, producing gases that increase intraabdominal pressure, a driving force behind acid reflux and GERD. The gas manufactured by these bacteria also contributes to bloating, abdominal pain, and diarrhea in IBS.
How can a ketogenic diet help with IBS and GERD? By significantly reducing dietary carbohydrate load, a ketogenic diet provides less fermentable substrate for gut bacteria, reducing the amount of gas produced in the small intestine. Several small studies indicate that a ketogenic diet improves abdominal pain, stool frequency, and reflux in patients with IBS-D and GERD, respectively. (30, 31) However, it is important to note that the long-term effects of a low-fermentable-carbohydrate diets, including the ketogenic diet, on gut bacteria remain to be seen. Our beneficial gut bacteria also require fermentable carbohydrates to survive, so it’s possible that the ketogenic diet could reduce their numbers. This is why I highly recommend following a cyclic ketogenic diet rather than a long-term, strict ketogenic diet. I’ll provide more information on that topic shortly.
8. Skin Conditions
A ketogenic diet may seem like an unlikely approach for treating skin issues. However, keto addresses several of the physiological mechanisms underlying dermatological issues, particularly acne and psoriasis, and can therefore help people correct the root cause of their skin conditions.
Insulin is a crucial driver of acne due to its effects on hormones, sebum production, and inflammation. By reducing insulin, the ketogenic diet may correct hormone imbalances, excessive sebum production, and inflammation, thereby alleviating acne. (32)
High blood sugar promotes psoriasis by increasing levels of a protein that causes inflammation. A ketogenic diet corrects hyperglycemia and may lower the level of this protein, resulting in the amelioration of psoriasis. (33)
9. Some Forms of Cancer
Some of the most exciting research on the ketogenic diet pertains to its applications in the treatment of cancer. A rapidly growing collection of animal studies indicates that the ketogenic diet has anticancer effects in malignant glioma, neuroblastoma, prostate cancer, and colon cancer. (34) In humans, a ketogenic diet has been found to work synergistically with antineoplastic agents in the treatment of malignant glioma, a common primary brain tumor that is notoriously difficult to treat. (35) Several small studies indicate that the ketogenic diet improves body weight and blood profiles while reducing a marker for tumor progression, TKTL1, in patients with breast, prostate, colon, melanoma, and lung cancers. (36, 37)
The ketogenic diet exerts anticancer effects by inducing a metabolic shift in malignant tissues that promotes apoptosis (self-programmed death) of cancer cells, inhibiting angiogenesis (the growth of new tumor-supporting blood vessels), reducing oxidative stress and inflammation, suppressing mTOR (a protein in humans involved in the regulation of cell growth and regeneration), and increasing the sensitivity of certain cancer cell types to chemotherapy. (38)
Since a ketogenic diet can induce weight loss, clinicians should take care to ensure that adequate calories are consumed to inhibit undesirable weight loss in cancer patients.
It is crucial to recognize that not all forms of cancer will respond to a ketogenic diet.
Research suggests that cancer cells with low levels of particular enzymes (the ketolytic enzymes 3-hydroxybutyrate dehydrogenase and succinyl CoA 3-oxoacid CoA transferase) are more susceptible to the anticancer effects of a ketogenic diet. Screening a patient’s cancer cells for these enzymes may represent a valuable strategy for determining whether a ketogenic diet may be of use. (39)

Who Should Avoid a Ketogenic Diet?
The ketogenic diet is not appropriate for everyone. If you fit any of the descriptions listed below, then a ketogenic diet may have a negative impact on your health.
You Have a Genetic Condition That Affects Fatty Acid Metabolism
Since fats are consumed in large quantities on a ketogenic diet, any genetic condition that impairs fatty acid metabolism precludes the use of this diet. If you have primary carnitine deficiency, pyruvate carboxylase deficiency, or any of the other genetic conditions listed here, a ketogenic diet is absolutely contraindicated.
You’re Pregnant or Breastfeeding
While a growing fetus can utilize ketones to an extent, it still requires a steady glucose supply to support normal growth, including crucial brain development. Reduced glucose availability caused by a maternal ketogenic diet may have long-term adverse effects on infant health, including abnormal growth patterns and alterations in brain structure. (40) If you are pregnant and struggling with blood sugar issues, a low-carbohydrate diet that includes moderate amounts of nutrient-dense carbohydrates, such as fruit and starchy tubers, is a safer choice than a ketogenic diet.
You Have Gallbladder Disease or No Gallbladder
The body needs bile to break down and digest dietary fat, and the gallbladder is responsible for storing bile before its release into the small intestine. Removal of the gallbladder and gallbladder disease cause fat malabsorption and may make it difficult to follow a ketogenic diet. If you have had your gallbladder removed or have existing gallbladder disease, consult with your doctor before trying a ketogenic diet.
You’re Suffering from Kidney Disease or Kidney Stones
While preliminary research suggests that a ketogenic diet may benefit chronic kidney disease patients, caution is advised in those with kidney disease or kidney stones. (41) If you have a kidney condition, consult with your doctor before starting a ketogenic diet.
You Have HPA Axis Dysfunction and High Levels of Stress
A ketogenic diet has been observed to raise cortisol, the body’s primary stress hormone. If you struggle with high levels of stress or HPA axis dysfunction, a ketogenic diet may push your stress-response system into overdrive and cause burnout. A diet that includes a moderate intake of carbohydrates is typically a better fit for those with high-stress lifestyles or HPA axis dysfunction.
You’re a Hyper-Responder to Dietary Cholesterol
While dietary saturated fat and cholesterol do not impact blood cholesterol levels in most people, they may raise total and LDL cholesterol in a subset of the population referred to as “hyper-responders.” If you are a hyper-responder (this is something you’ll need to determine with the help of your doctor), I recommend following a Mediterranean Paleo-style diet, an approach that is lower in fat and higher in Paleo-friendly carbohydrates, rather than a ketogenic diet.
You’re an Athlete
If you participate in exercise that involves explosive movements such as jiujitsu, mixed martial arts, CrossFit, or even some rigorous forms of dance, you may benefit from a moderate carbohydrate intake rather than a ketogenic diet. Explosive movements draw on your muscles’ glycolytic capacity, which is powered by glucose from dietary carbohydrates. Endurance athletes, on the other hand, may thrive on a ketogenic diet because their respective activities can be adequately fueled by fatty acid oxidation and ketones.

How Long to Follow the Ketogenic Diet
The ideal keto diet time frame must take into account both nutritional ketosis and fat adaptation. Ketosis means your body is experiencing an acute lack of glucose and is therefore producing ketone bodies for energy. Fat adaptation, on the other hand, means your body has become adapted to burning fat for fuel.
When you first embark on a ketogenic diet, your goal is to be in nutritional ketosis consistently. Over time, as you train your body to function on fewer carbohydrates, you may enter the fat adaptation phase. While ketosis can be achieved after just a few days of the diet, at least three to four weeks of strict adherence to the diet is required in order to reach the fat adaptation state. This is also the time frame during which you’ll likely begin to notice benefits of the diet.
While some keto proponents advocate following the diet long term, a cyclic ketogenic diet may be a healthier choice.
A cyclic ketogenic diet involves carb-loading one to two days of the week, followed by a standard low-carb ketogenic diet the remaining days of the week. Cyclic keto has many benefits—it allows the body to enter a state of ketosis regularly while also satisfying carb cravings, improving sleep, and promoting a healthier balance of gut bacteria.

The Three-Step Process to Starting Keto
Step 1: Find Your Macronutrient Ratio
The goal of a ketogenic diet is to transition the body’s primary fuel supply from carbohydrate to fat, creating a state of nutritional ketosis and, eventually, fat adaptation. The degree to which dietary carbohydrates need to be reduced to reach nutritional ketosis varies from person to person. Finding the optimal macronutrient ratios for getting your body into ketosis requires some self-experimentation. I recommend playing around with the ranges listed below to find the ones that work best for you.
Possible macronutrient ranges for keto:
60 to 75 percent of calories from fat
15 to 30 percent of calories from protein
5 to 10 percent of calories from carbohydrates
I would like to emphasize that the super-high-fat, low-protein version of keto promoted by some keto advocates is not necessary for most people to obtain the benefits of keto.
Proponents of the super-high-fat, low-protein approach argue that protein kicks the body out of ketosis by supplying amino acids for gluconeogenesis (simply put, turning non-carbs into fuel); however, research indicates that the impact of dietary protein on gluconeogenesis and glucose flux is nearly negligible, making this argument irrelevant.

(42) In my practice, we have found that usual protein intakes (15 to 20 percent of calories) do not have appreciable effects on blood ketone levels. Besides, a super-high-fat, low-protein diet typically has more drawbacks than benefits—it may cause weight gain, muscle loss, fatigue, and chronic hunger. Don’t be afraid of including plenty of protein in your ketogenic diet; protein is a powerful tool that will satiate your appetite while facilitating fat loss and preventing muscle loss.
Step 2: Don’t Count Calories
I don’t recommend counting calories on the keto diet. Tracking your macronutrients, on the other hand, can be helpful. Try using an app for journaling your food intake and obtaining your ratios of macronutrients. I recommend the Carb Manager Keto Diet App.
Step 3: Regularly Test Your Ketones
To determine whether you’re in ketosis and what degree of ketosis you’re in, test your ketones each morning. Blood ketone testing is the most accurate method—I do not recommend breath or urine ketone monitoring. In our practice, we recommend the Precision Xtra Blood Glucose Meter Kit, which can be purchased on Amazon (you can buy test strips for this meter in bulk on eBay for a lower cost). Keto Mojo is another good meter with affordable test strips.
If your ketone value is above 0.5 mmol/L first thing in the morning, you’re in ketosis. However, a range of 0.7 to 2.0 mmol/L is optimal for most people. If your value is above 3.0 mmol/L, you may not be eating enough and/or should consider adding some carbohydrates back to your diet. However, in the long run, your goal should not be a specific number on the ketone meter, but an improvement in your symptoms.

13 Tips and Tricks to Help You Follow a Ketogenic Diet
Following a ketogenic diet can take some work and planning. Here are some tips and tricks to help you get into ketosis faster.
1. Eat Enough Calories and Protein
Failing to consume enough calories on a keto diet can cause fatigue and insomnia, while an insufficient protein intake promotes weight gain and muscle loss. When you first begin a keto diet, it can be helpful to track your food intake with an app such as Carb Manager Keto Diet App; this will allow you to visualize your macronutrient intake and ensure that you don’t undereat calories or protein. As I mentioned earlier, a low-protein intake is not required to obtain the benefits of keto. A sufficient protein intake (15 to 30 percent of total calories) suppresses hunger and, in most people, does not affect blood ketone levels. (43)
2. Add Supplemental Fat
Fat is the primary source of fuel on a ketogenic diet, and supplementing with specific types of fat, particularly coconut oil and medium-chain triglyceride (MCT) oil, can help you get into ketosis faster. MCT oil is unique in that it increases ketone levels in a linear, dose-dependent manner and allows for the induction of ketosis with lower amounts of total fat in the diet. (44)
If you are a hyper-responder to dietary fat and cholesterol, you may need to restrict your intake of saturated fats on keto. Instead, focus on fats such as olive oil, avocados, fatty fish, nuts, and seeds.
3. Supplement
L-leucine is a ketogenic amino acid, meaning it can be used to make ketones. Supplementing with L-leucine may help you get your body into ketosis faster.
Exogenous ketones are ketones that are ingested as a nutritional supplement. They elevate blood ketone levels but may inhibit the body’s own process of ketogenesis. (45) I consider exogenous ketones an advanced strategy for those who have already nailed down the basics of keto.
4. Drink Apple Cider Vinegar
Consuming apple cider vinegar before meals not only assists digestion but may also promote ketone production due to its content of acetic acid, a naturally occurring ketogenic compound. Try adding a tablespoon or two to water and drinking before you eat your meal.
5. Increase Your Salt Intake
The body excretes more salt on a keto diet than on a standard diet due to reductions in insulin, which normally promotes a certain degree of water retention. Once you’re in ketosis, add an extra three to five grams of Himalayan, sea, or Redmond Real salt to your diet every day. (Five grams is about one teaspoon, but that may vary depending on the type of salt and the size of the grain.)
6. Eat More Magnesium and Potassium
In addition to sodium, levels of magnesium and potassium can also drop on a ketogenic diet due to its dehydrating effect on the body. Make sure to eat plenty of magnesium- and potassium-rich foods. Some of the best keto-friendly sources of magnesium are dark leafy greens, nuts and seeds, and cacao. Keto-friendly potassium sources include spinach, kale, avocados, and mushrooms.
7. Avoid Artificial Sweeteners
Artificial sweeteners such as saccharin (Sweet’N Low), aspartame (NutraSweet, Equal), and sucralose (Splenda) are quite popular among low-carb dieters. However, concerning new research indicates that artificial sweeteners have adverse metabolic effects and may work against your keto efforts by disrupting your gut microbiota and inducing insulin resistance and weight gain. (46, 47) If you want to use a non-caloric sweetener, I recommend either stevia or monk fruit sweetener.
8. Stock Up on Keto-Friendly Snacks
Keep keto-friendly snacks on hand so that when hunger strikes, you have healthy food at the ready; this strategy will help prevent you from falling off the keto wagon and reverting to high-carb snack foods. Nuts and seeds, coconut butter, grass-fed beef jerky, and hard-boiled eggs make for easy, portable keto snacks.
9. Try Intermittent Fasting
Intermittent fasting, an eating style in which you eat within a specific period each day and fast the rest of the time, is a great way to reduce the amount of time your body needs to enter nutritional ketosis. (48) Intermittent fasting accelerates the time to ketosis by keeping insulin levels low and raising ketone levels. If you’re new to intermittent fasting, start by limiting your eating to an eight- to 10-hour window each day and fasting for the remaining 14 to 16 hours of the day (and night).
10. Decrease Your Stress
Stress is an underappreciated but significant impediment to achieving success on a ketogenic diet. High stress elevates cortisol, which stimulates the generation of glucose (gluconeogenesis) in the liver. Gluconeogenesis raises blood glucose and reduces ketone levels; together, these effects make it difficult to enter ketosis.
Try these strategies for reducing your stress:
Set aside time for rest, ideally away from your smartphone and computer
Cut down on commitments
Get plenty of sleep
Start a mindfulness practice such as meditation
Spend time in nature
Spend quality time with friends and family
11. Prioritize Sleep
Inadequate sleep will rapidly derail your keto efforts by increasing your blood sugar and levels of stress hormones. Getting eight to nine hours of high-quality sleep per night should be a priority. Maintain a regular bedtime schedule and practice sleep hygiene strategies such as keeping your bedroom completely dark at night, lowering the ambient temperature to around 67 degrees Fahrenheit, and avoiding blue light exposure a couple of hours before bed with blue light-blocking glasses.
12. Exercise
Frequent exercise depletes glycogen stores, causing your body to turn to fat for energy; this means that regular exercise can help you get into ketosis faster. Some people experience a reduced capacity for exercise upon starting keto; in this case, engaging in longer durations of low-intensity activity, such as walking, cycling, or swimming, can help you get into ketosis without causing undue fatigue.
13. Drink Plenty of Water
Within the first few days of starting a ketogenic diet, you may experience a significant loss of water weight. This occurs primarily because glycogen stores in muscle are gradually being reduced, and glycogen causes retention of water. To ensure that you don’t become dehydrated on keto, drink half your weight in ounces of filtered water every day.

What to Expect When You’re on the Keto Diet
As your body gets used to keto, you may experience some uncomfortable side effects. Here’s what to expect.
The “Keto Flu”
The first few days of keto can be difficult as your body adjusts to a low carbohydrate intake; you may experience symptoms such as brain fog, headache, insomnia, irritability, and digestive issues. These symptoms are commonly referred to as the “keto flu” and are caused by the glycogen loss, low insulin levels, and dehydration that frequently occur when you suddenly cut back on carbs. Know that these symptoms will pass, especially if you make sure to drink plenty of water, replenish your electrolyte levels, and eat sufficient protein and calories. At the most, it may take a couple weeks for the keto flu to subside, but for most people, this uncomfortable period passes within a few days.
Constipation
Constipation is a common complaint for keto dieters. There are several reasons why you may experience constipation:
You’re not eating enough fiber. It’s easy to eat lots of meat, cheese, and oils on a ketogenic diet at the expense of optimal fiber intake. Be sure to eat plenty of colorful non-starchy vegetables (broccoli, cauliflower, kale, bell peppers, mushrooms) because the fiber in these foods will keep things moving through your digestive tract.
You may need more water. As I mentioned earlier, people typically experience body water loss when starting a ketogenic diet. Your digestive tract needs water to keep fecal matter soft and moving through your intestines; if you are dehydrated, constipation is likely.
Try resistant starch. Resistant starch passes through the small intestine intact and therefore doesn’t count as a dietary carbohydrate. Instead, it travels to your large intestine, where it’s used to feed beneficial gut bacteria. Try adding a teaspoon of resistant starch, such as raw potato starch or green banana flour, to your keto smoothie each day to keep your gut happy.
Take a probiotic and eat fermented foods. The beneficial bacteria in probiotics and fermented foods help prevent sluggish digestion and promote healthy bowel function.
Reduced Thyroid Function
Research has found that a ketogenic diet decreases levels of T3, the body’s active thyroid hormone. (49) Unfortunately, this means a ketogenic diet may not be optimal for those with pre-existing hypothyroidism. If you have hypothyroidism and want to proceed with a ketogenic diet, consult with your doctor first because you may need thyroid support.
Elevated Cortisol
Research has indicated that a ketogenic diet raises the stress hormone cortisol to increase energy levels in the face of reduced carbohydrate availability. However, it is still up for debate whether this increase in cortisol is harmful or innocuous. Nonetheless, I recommend taking extra care to manage your stress while on a ketogenic diet. Getting plenty of sleep, exercising, and engaging in a regular stress-reduction practice can help you keep your baseline stress levels low and reduce the potential for chronically elevated cortisol.

Miracle Mayonnaise #lowcarb

Bowl containing home-made Miracle Mayonnaise
Home-made mayo mixed with chopped celery, red peppers and tomatoes.

Chums, I have a new recipe for you that will TRANSFORM your life.

A bold claim, I know, but this nifty trick will help you bash up a batch of home-made mayonnaise in less than 30 seconds. I have timed it. No more standing there trickling oil in drop by drop and curdling it when you slip up and pour too much oil in. No—this is foolproof.

Several weeks ago, I watched TV chef John Torode make this on Celebrity MasterChef. He was demonstrating how the contestants should make mayonnaise if they were to recreate his recipe in the time specified. The two celebrities trying the recipe out did not use his method, opting for the conventional mayonnaise method, but John’s way intrigued me. That couldn’t work, surely…?

Glory be. It does. Super, super easy. I love Hellman’s Mayonnaise but I am also queen of the home-made, and with mayonnaise you get to control the oil. Commercial brands use cheap vegetable oils. For my version, I used Cretan olive oil—a mild one as the extra virgin stuff is too strong for mayonnaise.

Here is the recipe. Try it. Be amazed.

Miracle Mayonnaise

  • Servings: 4-6
  • Difficulty: easy
  • Print

A fresh, easy to make mayonnaise you can use for salads, veggies, fish, ham and eggs.


You will need a stick blender and a tall, narrow vessel. I used a Pyrex jug.

Ingredients


1 large whole egg

250ml lighter olive oil, or a mix of olive and rapeseed oil

salt and pepper

1 tbsp lemon juice or apple cider vinegar

1tsp Dijon mustard

Directions

  1. Crack the egg into your vessel. Add the mustard and salt and pepper. Pour the oil on top.
  2. Push your blender down so it is on top of the egg. Press it on and whizz until you get a thick sauce.
  3. Add the lemon juice or vinegar, blend again and taste. Add more salt and pepper if necessary.
  4. Place in a sterilised jar and store in the fridge. It will last four or five days.

Please note: this recipe contains raw eggs. According to the NHS, in the UK vulnerable groups such as the elderly, infants, children and pregnant women can eat raw or lightly cooked eggs but they should be British Red Lion stamped, hen’s eggs and come from the UK.

 

 

 

 

Kris Kresser: Lesser known symptoms of wheat intolerance

The Symptoms of Gluten Intolerance You Haven’t Heard About
by Chris Kresser
Last updated on April 18, 2019

Brain fog, skin issues, depression, and even anemia are all symptoms of gluten intolerance.
You just don’t feel good. You’re tired and get frequent headaches, have ongoing skin issues, or struggle with depression—or all of the above. Maybe you’ve wondered if gluten could be the culprit, but because you don’t experience gastrointestinal upset, you’ve since put the thought out of your mind and haven’t mentioned anything to your doctor. Or perhaps you’ve shared your suspicion, but conventional testing ruled out celiac disease (CD) and thus, supposedly, any issues with gluten. In either case, your diet has likely stayed the same … and so have these often-overlooked symptoms of gluten intolerance.
Yes, all of the symptoms mentioned here—and many others you may not have heard about—can be signs that you have a significant degree of gluten intolerance. Even if you don’t run to the bathroom right after enjoying a plate of pasta, and even if standard lab work says otherwise, your body (and brain) may be having serious problems with gluten. Let’s explore these lesser-known symptoms and discuss if going gluten free is right for you.
You’ve heard of the havoc gluten can wreak on your digestive tract, but did you know that gluten intolerance can cause skin problems, depression, and frequent headaches? Check out this article for more symptoms of gluten intolerance you’ve never heard of.

Undiagnosed Intolerance Is More Common Than You May Think
First off, I want you to know that if you eat gluten and you feel lousy but you don’t have digestive issues—and you have tested negative for CD and been told it’s all in your head—you are not alone. In fact, undiagnosed cases of gluten intolerance are incredibly widespread. Here’s why.
As I’ve written before, wheat contains several different classes of proteins: gliadins (of which there are four different types, including one called alpha-gliadin); glutenins; agglutinins; and prodynorphins. Once wheat is consumed, enzymes in the digestive tract called tissue transglutaminases (or tTGs) help break down the wheat compound. During this process, additional proteins are formed, such as deamidated gliadins and gliadorphins (also called gluteomorphins). Stick with me here—these terms are worth knowing so that you can understand the pitfalls of conventional testing for CD.
CD is a serious form of gluten intolerance, one that can do real damage to the tissues in the small intestine (though its symptoms aren’t merely gut related). CD is characterized by an immune response to one specific gliadin (the aforementioned alpha-gliadin) and one specific type of transglutaminase (tTG-2). But people can—and very much do—react to several other components of wheat and gluten.
Therein lies the problem, because conventional lab testing for CD and gluten intolerance only screens for antibodies to alpha-gliadin and tTG-2.
If your body reacts to any other wheat protein or type of transglutaminase, even severely, you’ll still test negative for CD and intolerance.
Statistics suggest that for every one case of CD that is diagnosed, 6.4 cases remain undiagnosed—the majority of which are atypical forms without gastrointestinal symptoms; even many patients who are eventually diagnosed don’t experience an upset stomach after consuming gluten. (1)
What’s more, the distinct autoimmune response to wheat proteins and transglutaminase enzymes in the gut that defines CD is just one possible expression of gluten intolerance. The many other ways a sensitivity to gluten can affect the body are collectively referred to as non-celiac gluten sensitivity, or NCGS. Cases of gluten intolerance classified as NCGS involve both intestinal and non-digestive reactions to gluten that are not autoimmune or allergic in nature and that resolve when gluten is eliminated from the diet.
There is no definitive diagnostic test for NCGS, making it difficult to put a number on its prevalence. By some estimates, it may occur in as many as one in 20 Americans. (2) And although your doctor and plenty of others out there might still insist that NCGS doesn’t truly exist, several studies have validated it as a distinct clinical condition. (3) As I’ve explained previously, gluten sensitivity is very real. Stories painting NCGS as a collective delusion have gotten it wrong.
Decoding Your (Real) Symptoms
Gluten intolerance can affect nearly every tissue in the body, including the brain, skin, endocrine system, liver, blood vessels, smooth muscles (found in hollow organs such as the intestines), and, yes, stomach.
That’s why it can manifest either in the classic presentation of digestive distress—abdominal pain, bloating, gas, and diarrhea or constipation—or in any of the following, likely surprising, non-digestive symptoms.
Anemia
Although it’s discussed infrequently in popular articles, iron-deficiency anemia is well documented as a symptom of gluten intolerance in scientific studies. (4, 5) In fact, research suggests that it may often be the first noticeable symptom of CD and that up to 75 percent of those with an anemia diagnosis may be gluten intolerant. (6, 7) Gluten intolerance can interfere with the uptake of iron from food, causing malabsorption of this important nutrient. (8) What’s more, because anemia generally saps one’s energy, it can trigger or worsen the next non-digestive sign of gluten intolerance on this list.
Fatigue
Many gluten-intolerant individuals report feeling tired and fatigued, especially right after eating, you guessed it, gluten. (9) Research has linked NCGS to chronic fatigue symptoms in some people. (10) As with chronic fatigue syndrome, symptoms of gluten intolerance can also include muscle fatigue and muscle and joint pain.
Brain Fog
This type of cognitive dysfunction can be a sign of gluten sensitivity. Those affected often describe experiencing “foggy mind” symptoms such as an inability to focus and concentrate; some also describe feeling mentally fatigued. (11, 12)
Headaches
Headache is a frequent finding in NCGS, with one recent study reporting the symptom in more than half of its participants. (13, 14, 15) Migraine in particular is an associated symptom. (16, 17)
Eczema and Other Skin Disorders
As with fatigue, brain fog, and headaches, people with NCGS may notice a worsening of skin symptoms such as eczema, rash, and undefined dermatitis after ingesting gluten-containing foods. The most commonly reported skin lesions include those similar to subacute eczema, as well as the bumps and blisters indicative of dermatitis herpetiformis, or Duhring’s disease—to which CD is closely linked. Those who are gluten intolerant may also experience scaly patches resembling psoriasis. Lesions are typically found on the muscles of the upper limbs. (18, 19, 20)
Depression and Anxiety
One of the main reasons gluten sensitivity often goes unrecognized and untreated, researchers theorize, is because mental health issues can be a hallmark of this condition. Data suggests that up to 22 percent of patients with CD develop such dysfunctions, with anxiety and depression occurring most commonly. One study found that CD patients were more likely than others to feel anxious in the face of threatening situations, while additional research has linked conditions such as panic disorder and social phobia to gluten response. Depression and related mood disorders appear to occur with both NCGS and CD. (21, 22)
Here’s the good news: The majority of studies cited here not only investigated whether or not these symptoms are signs of gluten intolerance, but also whether or not they can be addressed by going gluten free. And it turns out, these problems improved or completely resolved with adherence to a gluten-free diet.
But more on that in a minute.
Beware These Surprising Consequences of Intolerance
While the symptoms mentioned above are what will most likely clue you in to your body’s negative response to gluten, they aren’t the only effects of intolerance to be aware of. In fact, a variety of chronic diseases may develop due to long-term CD or NCGS, including: (23, 24)
Epilepsy
Attention-deficit hyperactivity disorder, or ADHD
Autism spectrum disorders
Schizophrenia
Type 1 diabetes
Osteoporosis
Multiple sclerosis
Hashimoto’s
Peripheral neuropathy
Amyotrophic lateral sclerosis, or ALS
In one study, researchers found a strong link between gluten sensitivity and neurological complications—especially those in which the cause was unknown. (25) Research has even shown that, for some people with gluten sensitivity, the primary symptom they experience is a neurological dysfunction. (26) The data suggests that nearly 60 percent of people with neurological dysfunction of unknown origin test positive for anti-gliadin antibodies. (27)
Challenge Yourself: Do You Feel Better on a Gluten-Free Diet?
If you’re currently experiencing any of the symptoms of gluten intolerance I shared in this article and can’t seem to find relief, or if you have received a diagnosis of any of the above linked diseases or disorders and you and your doctor have not found a probable cause or resolution, gluten could very well be a trigger for you.
Because of the limitations of current testing for CD and the lack of diagnostic options for NCGS, the most reliable test for gluten intolerance is a “gluten challenge.”
This involves removing gluten from your diet completely for a period of at least 30 days—60 days is best—then adding it back in after that time has elapsed. If your symptoms and/or diagnosis improve during the elimination period and return when gluten is reintroduced, let your healthcare provider know. You have NCGS or atypical CD.
Though I consider this to be the gold-standard test for gluten intolerance, Cyrex Laboratories does offer a comprehensive blood panel that screens for all of the wheat and gluten proteins and transglutaminase enzymes discussed earlier. It can be a helpful diagnostic tool, but it shouldn’t replace a gluten challenge. (Note: It must be ordered by your physician or another healthcare provider.)
How Will You Deal with Your Symptoms of Gluten Intolerance?
If you experience improvement on a gluten-free diet and plan to continue eating this way, you can feel confident that there is no risk in terms of nutrient deficiencies to removing gluten from your diet. (28) If anything, my experience has shown me that people who eat gluten-free are more likely to increase their intake of essential nutrients, especially if they replace breads and other flour products with whole foods.
Have you experienced any of these symptoms? Are you planning a gluten challenge to determine once and for all if gluten is the culprit? Let me know below in the comments!

My comments: My anaemia, post wheat meal fatigue and brain fog, irritable bowel, and mouth ulcers all went away when I stopped wheat. And they recurred after four days of eating wheat after a long period of abstinence.  We discuss how you can meal plan and bake without wheat on this blog site and in our book.

Kris Kresser: The Carnivore Diet, is it really healthy?

The Carnivore Diet: Is It Really Healthy?
by Chris Kresser
Published on February 6, 2019

 

My comment: There has been a lot of publicity about the benefits of an all meat diet, the opposite end of the spectrum from veganism.  Dr Jordan Petersen’s daughter has overcome considerable health problems and she puts it down to an all beef diet. In this post Kris shares information, the good and the not so good about such an extreme diet.
The carnivore diet is a hot eating trend, and many people have reported significant benefits from adopting an all-meat diet. But is consuming only meat healthy in the long term? Read on to understand the mechanisms behind the diet, the potential consequences of not eating plant foods, and a few alternatives to going pure carnivore.

Is an all-meat, carnivore diet healthy? 
In my recent debate on the Joe Rogan Experience with Dr. Joel Kahn, I touched briefly on the carnivore diet. I’m a huge believer that meat is an essential part of a healthy diet, but eating an all-meat diet is an entirely different subject, and I think we need to be very careful about assuming that an intervention that works well in the short term will also be safe and effective in the long term.
In this article, I’ll discuss the diets of ancestral populations, how the carnivore diet affects the body, my concerns about the potential consequences of such a restrictive diet in the long term, and alternative dietary approaches that might offer the same benefits without having to go pure carnivore.
Are you considering going carnivore? The all-meat diet is trending, but completely dropping plant-based food off your plate could have a significant impact on your health. Check out this article for a breakdown on the strengths and weaknesses of the carnivore diet. #chriskresser

What Is the Carnivore Diet?
The carnivore diet is pretty straightforward: eat only animal foods and stay away from all plant foods. This means that you are primarily getting your energy from protein and fat and are consuming close to zero carbohydrates.
Many people who have adopted the carnivore diet report faster weight loss, improved mental clarity, healthier digestion, and even improved athletic performance. I certainly don’t doubt the anecdotal reports of people that have found remarkable relief from debilitating chronic health problems with this diet. For many of these people, nothing else they had tried worked.
However, when considering the health of a dietary or lifestyle intervention, I’ve long believed that we should look at the big picture: historical evidence from other populations, plausible mechanisms that explain its effect on our bodies, and scientific data regarding outcomes.
Were Any Ancestral Populations Carnivores?
Let’s start with a brief look at the diets of some supposedly “carnivorous” ancestral populations. Indeed, many ancestral groups thrived on large quantities of animal products. However, every single one of these groups also took advantage of plant foods when they were available:
The nomads of Mongolia nourished themselves on meat and dairy products, but also gained nutrients from their consumption of wild onions and garlic, tubers and roots, seeds, and berries. (1)
Gaucho Brazilians consumed mostly beef, but they supplemented their diet with yerba mate, an herbal infusion rich in vitamins, minerals, and phytonutrients. (2)
The Maasai, Rendille, and Samburu from East Africa primarily ate meat, milk, and blood. Young men almost exclusively ate these animal products but also occasionally consumed herbs and tree barks. Women and older men consumed fruit, tubers, and honey. (3)
The Russian Arctic Chukotka subsisted on fish, caribou, and marine animals but always ate them with local roots, leafy greens, berries, or seaweed. (4)
The Sioux of South Dakota ate great amounts of buffalo meat, but they also ate wild fruit, nuts, and seeds that they found as they followed the buffalo herds. (5)
The Canadian Inuit lived primarily on walrus, whale meat, seal, and fish, but they also went to great lengths to forage wild berries, lichens, and sea vegetables. They even fermented some of these plant foods as a way of preserving them. (6)
Every culture we know of that has been studied ate some combination of animal and plant foods. This does not necessarily mean that animal or plant foods are required to remain healthy, but it does speak to the ancestral wisdom of these cultures.
Five Reasons Why the Carnivore Diet Works
When any diet, drug, or other intervention “works,” it’s important to try to understand the mechanism behind it. In the case of the carnivore diet, there are several reasons that might explain the benefits people report.
1. The Carnivore Diet Can Restrict Calories and Mimics Fasting
Ever felt stuffed after you ate a huge steak? Protein is very satiating, meaning it fills you up and sends signals to your brain that you’ve consumed enough food. It’s no surprise that people report not feeling very hungry and start eating less frequently when they adopt an all-meat diet.
Food habituation may also play a role here. When you eat the same thing day after day, your brain doesn’t get as much reward value from food, so you start to eat less food overall—even if the food is usually something you find rewarding, like a big juicy steak.
The ultimate result is unintentional caloric restriction. Caloric restriction sets off a number of changes. When caloric intake drops, the concentration of insulin, insulin-like growth factor 1 (IGF-1), and growth hormone are significantly reduced. This condition triggers autophagy, which literally means “self-eating”—an internal process of cleaning up old cells and repairing damaged ones. Autophagy is also induced during fasting.
This may be why caloric restriction is so effective at reducing inflammation and alleviating symptoms of autoimmune disease. (7) Of course, caloric restriction also results in weight loss. These are arguably the two primary reasons that people seem to be drawn to the carnivore way of eating, but these effects might also be achieved through simple caloric restriction.
2. The Carnivore Diet Is a Low-Residue Diet
“Residue” is essentially undigested food that makes up stool. A low-residue diet is a diet that limits high-fiber foods like whole grains, nuts, seeds, fruits, and vegetables. It is often prescribed for people with inflammatory bowel disease (IBD) or irritable bowel syndrome (IBS) to alleviate symptoms like diarrhea, bloating, gas, and abdominal pain. (8)
Meat is made primarily of protein and fat, which are absorbed high up in the GI tract, leaving little residue leftover to irritate or inflame the gut. In other words, an all-meat diet is effectively a very low-residue diet and gives the gut a rest.
3. The Carnivore Diet Is Often Ketogenic
If you’re eating large amounts of meat but are only eating once or twice a day and adding extra fat to the meat, your diet is likely ketogenic. A ketogenic diet is a high-fat, moderate-protein diet, with:
60 to 70 percent of energy from fat
20 to 30 percent of energy from protein
5 to 10 percent of energy from carbohydrates
While the carnivore diet has no such macronutrient ratios, it’s likely that some of the benefits that come with eating meat alone are due to the body being in a state of ketosis.
Ketogenic diets have been shown to be helpful for a wide variety of conditions, including multiple sclerosis, diabetes, and neurological conditions like Parkinson’s disease and Alzheimer’s. (9, 10)
4. The Carnivore Diet Changes the Gut Microbiota
Switching to an all-meat diet can also rapidly alter the gut microbiota. A 2014 study found that putting healthy human volunteers on an animal-based diet resulted in significant changes to the gut microbiota in less than 48 hours. (11) The animal-based diet increased the abundance of bile-tolerant organisms and decreased the levels of microbes known to metabolize different plant fibers.
The gut microbiota has been linked to virtually every chronic inflammatory disease that has been studied, so it’s no surprise that an intervention that drastically changes the gut microbiota could have significant implications for health. (12)
The Biggest Potential Problem with This Diet: Nutrient Deficiencies
Now that we’ve established some of the mechanisms involved, the big question is: is the carnivore diet safe?
The short answer is that we really don’t know, since there are no long-term studies that have tracked large groups of individuals on carnivore diets for any significant length of time. One of my chief concerns about it is that it lacks several nutrients that are crucial for health.
There are four micronutrients that are especially difficult to obtain on a meat-only diet. Based on a typical carnivore diet and the Dietary Reference Intakes (DRIs) established by the Institute of Medicine, these include:
Vitamin C: An antioxidant that boosts immune cell function and is important for stimulating collagen synthesis
Vitamin E: An antioxidant that prevents the oxidation of lipids and lipoproteins
Vitamin K2: A fat-soluble vitamin that reduces the calcification of blood vessels
Calcium: A mineral required for healthy bones, muscle contraction, and nerve transmission
If dairy is included in the diet, this will cover vitamin K2 and calcium. However, if you don’t like organ meats, the number of potential micronutrient deficiencies increases significantly. In that case, you can add to the list:
Vitamin A: A fat-soluble vitamin important for proper vision and maintaining immune defenses
Folate: A B vitamin important for cell growth, metabolism, and methylation
Manganese: A trace mineral needed for the proper function of the nervous system, collagen formation, and protection against oxidative stress
Magnesium: A mineral that supports more than 300 biochemical reactions, including energy production, DNA repair, and muscle contraction
It’s also important to note that vitamin C is extremely heat sensitive, so only fresh or very gently cooked organ meats will have appreciable amounts.
Many carnivore dieters claim that the nutrient requirements for the general population simply don’t apply to them. Anecdotally, I know of several individuals who have consumed a carnivore diet for three or more years without any overt signs of nutrient deficiencies.
Still, we’re lacking data. Currently, the DRIs are the best we have to go off of, and I don’t think we have enough evidence to unequivocally say that this diet has no risk of producing nutrient deficiencies in the general population.
Should We Be Aiming Higher Than the Daily Recommended Intake?
Even if the carnivore diet were sufficient to prevent outright deficiency, we should also consider metabolic reserve. Metabolic reserve is the capacity of cells, tissues, and organ systems to withstand repeated changes to physiological needs. In other words, it’s having enough nutrients “in the bank” to be able to deal with a major stressor, injury, or environmental exposure. (13) So if an all-meat dieter manages to meet a recommended nutrient intake, it still may not be enough for optimal health.
Other Reasons an All-Meat Diet May Not Be Healthy
It Lacks Beneficial Phytonutrients
Phytonutrients are chemicals that are produced by plants to protect against environmental threats, such as attacks from insects and disease. They can also have major benefits for our health. Curcumin, beta-carotene, quercetin, and resveratrol are all examples of common phytonutrients.
Some proponents of the carnivore diet suggest that phytonutrients are toxic to humans, and that it’s best to eliminate them completely from our diet. However, many of these “toxins” act as acute stressors that actually make us stronger through a process called hormesis.
Much like resistance training is an acute stressor that leads our muscles to adapt and get stronger, exposure to small amounts of phytonutrients is a hormetic stressor that activates several different pathways in the body, ultimately serving to reduce inflammation, enhance immunity, improve cellular communication, repair DNA damage, and even detoxify potential carcinogens. (14, 15)
It Might Affect Hormones, Fertility, and Thyroid Function
We have zero long-term data about how an all-meat diet impacts hormones, thyroid function, and fertility. I have written before about why carbohydrates are particularly important for female fertility and why very-low-carb diets may not be the best choice during pregnancy.
Carbohydrates are particularly important for supporting thyroid function since insulin stimulates the conversion of inactive thyroid hormone T4 to active T3. In fact, traditional cultures that ate largely animal products and had little access to plant foods often went to great lengths to support fertility, including eating the thyroid glands of the animals they hunted. (16)
My guess is that most modern “carnivores” are not consuming the thyroid glands of animals and are therefore at risk for suboptimal thyroid function and (at least temporary) infertility.
It Could Overtax Your Liver (If You’re Eating Lean Meat)
When you don’t eat sufficient carbohydrates and fat, your liver can make glucose from protein via a process called gluconeogenesis. This process creates nitrogen waste, which must be converted to urea and disposed of through the kidneys.
While this is a normal process that occurs in every human being, there is a limit to how much protein the liver can cope with safely. More than 35 to 40 percent of total calories as protein can overwhelm the urea cycle, leading to nausea, diarrhea, wasting, and, potentially, death. For pregnant women, this threshold may be as low as 25 percent of total calories. (17)
Interestingly, anthropological evidence suggests that hunters throughout history avoided consuming excess protein, even discarding animals low in fat when food was scarce. (18)
In short: When eating meat, it’s important to have a good amount of healthy fats or quality carbohydrates as well.
Is the Carnivore Diet the Ideal Human Diet?
In the last section, I outlined several potential concerns with the carnivore diet. But this leads me to another important question: even if the carnivore diet is safe, is it really the best diet for optimal health?
While you might be able to get away with a vegetarian or carnivorous diet for a short while, the evidence suggests that the ideal diet includes both animal and plant foods. Dr. Sarah Ballantyne broke this down in part three of her series “The Diet We’re Meant to Eat: How Much Meat versus Veggies.”
While you can theoretically get all of your nutrients from one group alone (and potentially supplement with any missing nutrients from the other group), we need both sets of nutrients to be optimally healthy, and consuming animal and plant foods in their whole form is the best way to accomplish this.
Five Alternatives to the Carnivore Diet
Here are some options that might provide the same therapeutic benefits that the carnivore diet can offer—but without as much potential risk.
1. A Low-Carb Paleo Diet
Some people trying a carnivore diet are going straight from the Standard American Diet to pure carnivore. Oftentimes, a low-carbohydrate Paleo template might provide some of the same benefits, including weight loss, improved insulin sensitivity, and an alleviation in autoimmune symptoms. (19, 20, 21)
2. A Fasting Mimicking Diet
A fasting mimicking diet can reverse type 1 and type 2 diabetes, alleviate age-dependent impairments in cognitive performance, and protect against cancer and aging in mice. (22, 23, 24) In humans, the fasting mimicking diet was found to significantly reduce body weight, improve cardiovascular risk markers, lower inflammation, and potentially improve symptoms of multiple sclerosis. (25, 26)
3. Periodic Prolonged Fasting
Undergoing a 72-hour fasting once every few months could also achieve many of the benefits boasted by the carnivore diet. Prolonged fasting causes organs to shrink and then be rejuvenated as damaged cells are cleared out and stem cell pathways are activated. (27)
4. A Ketogenic Diet
The ketogenic diet has been very well studied and has documented benefits for epilepsy, neurodegenerative disease, and autoimmune disease. Ketones themselves are potent anti-inflammatories. (28, 29)
5. Addressing Gut Pathologies
If a healthy lifestyle coupled with the dietary approaches above is insufficient to control your symptoms, consider working with a Functional Medicine practitioner who is knowledgeable about gut health. If you’re thinking about becoming a strict carnivore because you’re experiencing adverse reactions to even very small amounts of plant foods, that’s likely a sign of an underlying gut infection that should be addressed.
Share this with friends and family who might be considering an all-meat diet, and be sure to leave your thoughts in the comments below.
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Type ones on low carb diets experience less hypoglycaemia

Adapted from Why low carb diets for type one patients? Jun1 2019 by Emma Kammerer Pharmacy Doctorate Candidate Bradenton School of Pharmacy originally published in Diabetes in Control.

Both Dr Jorgen Neillsen and Dr Richard Bernstein have shown that insulin users have fewer attacks of hypoglycaemia and that the attacks are less severe.  A new randomised controlled study by Schmidt et al confirms this finding.

Studies have shown that when a high carb diet is consumed there 20% greater error in carbohydrate estimation compared to when a low carb diet is chosen. This then affects the insulin dose administered, and thus the resulting blood sugars.

Schmidt wanted to look at the long term effects on glycaemic control and cardiovascular risk in type one patients on a low carb diet compared to a high carb diet.

The study was a randomised open label crossover study involving 14 adults who had had diabetes for more than 3 years, to eliminate the honeymoon effect. The patients went on one diet for 12 weeks, had a washout period of another 12 weeks, and then took up the other diet.  This was done so that the glycated haemoglobin levels would not be carried over from one diet to the next.

A low carb diet was defined as less than 100g carb a day and a high carb diet as over 250g per day.

Patients were given individualised meal plans and education on how to eat healthy carbs, fats and proteins. They all were experienced insulin pump users. They were asked to record total carbohydrate eaten but not the food eaten. Measurements were taken on fasting days on the first and last day of the study periods.

Blood glucose levels were downloaded from continuous glucose monitoring devices.

Four patients dropped out of the study so ten completed the test which was considered satisfactory by the statistician involved.

Results showed that the time spent in normal blood sugar range 3.9 to 10 mmol/L ( USA 56-180) was not significantly different for each diet.

The time spent in hypoglycaemia, below 3.9 (USA 70) was 25 minutes less a day on the low carb diet, and six minutes less a day below 3.0 (USA 56).

On the low carb diet glycaemic variability was lower and  there were no reports of severe hypoglycaemia.

On the high carb diet, significantly more insulin was used, systolic blood pressure was higher and weight gain was more.

There was no relevant changes in factors for cardiac risk between the two study arms.

The study showed that a low carb diet can confer real advantages to type one patients but education on how to conduct a low carb diet and manage the lower doses of insulin is required.

Schmidt, Signe et al. Low versus high carbohydrate diet in type 1 diabetes: A 12 week randomised open label crossover study. Diabetes, Obesity and Metabolism. 2019 March 26.

 

 

Eating carbs last gives lower blood sugar spikes

From IDDT newsletter December 2018

A report in BMJ Open Diabetes Research and Care Sept 2017 shows that in type two diabetes, eating sugar and starch later in the meal halved the blood sugar spike after the meal compared with those who ate the sugar and starch first.

This study was done on 16 people who ate test meals of protein, vegetables, bread and orange juice. Those who were instructed to eat the bread and juice last also had 40% lower post meal glucose levels compared to those who ate all of the meal components in a mixed fashion.

My comment: This is a small study but easily reproducible with yourself and your blood glucose meter. If you do wish to eat sugar and starch best have these last, unless you are treating a hypo.