iherb.com

October 1, 2014

I have found http://www.iherb.com to be very good value, reliable and fast. They are a large US based supplement company.

Delivery from the USA to Australia has always been under 1 week, and only costs $8.

For you first order, you can use my iHerb gift code QDD516 www.iherb.com to get $10 off if the order is $40 or more. Declaration: I will also get a small discount off my next order. You will get a gift code you can give to your friends.

Products that I often recommend include:

Choline bitartrate 500mg

Myo-inositol

There is a very scientific rational basis to taking certain supplements. I will be writing a blog post on supplements shortly- please look out for it!

Wishing you and your loved ones the best of health!

Dr Ben Balzer


The Zoo in your Poo (TM)

September 29, 2014

I’ll be writing about the zoo in your poo (TM) soon. The germs in the large bowel are called our microbiota. They play a critical role in health and disease and our understanding is exploding. Until recently it was thought that the role of the large bowel was simply to extract water from the bowel motions- this is incredibly and tragically wrong. Stay posted for more!


Published research on Paleo diets.

September 28, 2014

Here is a list of published research on contemporary Paleo type diets. You can look up the abstracts on www.pubmed.com and many of the papers can be found on Prof Loren Cordain’s website www.thepaleodiet.com under research.

There are thousands of more studies on traditional hunter gatherers etc. These studies are interventions where people are given Paleo type diets and the effects are measured, critically including head to head study with a standard dietitian type diet.

1. Frassetto LA, Schloetter M, Mietus-Synder M, Morris RC, Jr., Sebastian A: Metabolic and physiologic improvements from consuming a paleolithic, hunter-gatherer type diet. Eur J Clin Nutr 2009.

2. Jönsson T, Granfeldt Y, Ahrén B, Branell UC, Pålsson G, Hansson A, Söderström M, Lindeberg S.. Beneficial effects of a Paleolithic diet on cardiovascular risk factors in type 2 diabetes: a randomized cross-over pilot study. Cardiovasc Diabetol. 2009;8:35

3. Jonsson T, Granfeldt Y, Erlanson-Albertsson C, Ahren B, Lindeberg S. A Paleolithic diet is more satiating per calorie than a Mediterranean-like diet in individuals with ischemic heart disease. Nutr Metab (Lond). 2010 Nov 30;7(1):85

4. Lindeberg S, Jonsson T, Granfeldt Y, Borgstrand E, Soffman J, Sjostrom K, Ahren B: A Palaeolithic diet improves glucose tolerance more than a Mediterranean-like diet in individuals with ischaemic heart disease. Diabetologia 2007, 50(9):1795-1807.

5. O’Dea K: Marked improvement in carbohydrate and lipid metabolism in diabetic Australian aborigines after temporary reversion to traditional lifestyle. Diabetes 1984, 33(6):596-603.

6. Osterdahl M, Kocturk T, Koochek A, Wandell PE: Effects of a short-term intervention with a paleolithic diet in healthy volunteers. Eur J Clin Nutr 2008, 62(5):682-685.

7. Ryberg M, Sandberg S, Mellberg C, Stegle O, Lindahl B, Larsson C, Hauksson J, Olsson T. A Palaeolithic-type diet causes strong tissue-specific effects on ectopic fat deposition in obese postmenopausal women. J Intern Med. 2013 Jul;274(1):67-76

8. Frassetto LA, Shi L, Schloetter M, Sebastian A, Remer T.Established dietary estimates of net acid production do not predict measured net acid excretion in patients with Type 2 diabetes on Paleolithic-Hunter-Gatherer-type diets. Eur J Clin Nutr. 2013 Sep;67(9):899-903.

9. Jönsson T, Granfeldt Y, Lindeberg S, Hallberg AC.Subjective satiety and other experiences of a Paleolithic diet compared to a diabetes diet in patients with type 2 diabetes. Nutr J. 2013 Jul 29;12:105.

10. Fontes-Villalba M, Jönsson T, Granfeldt Y, Frassetto LA, Sundquist J, Sundquist K, Carrera-Bastos P, Fika-Hernándo M, Picazo O, Lindeberg S. A healthy diet with and without cereal grains and dairy products in patients with type 2 diabetes: study protocol for a random-order cross-over pilot study – Alimentation and Diabetes in Lanzarote -ADILAN. Trials. 2014 Jan 2;15(1):2

11. Mellberg, C., Sandberg, S., Ryberg, M., Eriksson, M., Brage, S., Larsson, C., et al. (2014). Long-term effects of a Palaeolithic-type diet in obese postmenopausal women: a 2-year randomized trial. European Journal of Clinical Nutrition. doi:10.1038/ejcn.2013.290


Evolution, energy and the logistic function.

April 27, 2014

This is a technical post on how the availability of food energy (kilojoules/ calories) affects population growth and competition. It is technical and is for advanced readers.

I would be very interested in any up to date review as I have been using a model created in the 1800’s with Verhlust’s Logistic Function which mathematically models Malthus‘ ideas. While this seems to work with many things, I would be interested in a more modern model.

Logistic Function Curve

Logistic Function Curve

Above is the basic growth curve of the logistic function vs time. (from Wikipedia). The start of the curve shows that the founder population slowly establishes itself, then thrives, then plateaus and finally reaches the peak population density- the carrying capacity of the environment.

“Letting P represent population size (N is often used in ecology instead) and t represent time, this model is formalized by the differential equation:

Logistic Equation in population growth

Logistic Equation in population growth

where the constant r defines the growth rate and K is the carrying capacity.” (Wikipedia)

In a long term natural situation the population has hit the carrying capacity which is determined by the available calories (and predator activity and illness etc). When the Neolithic diet  came along, then the available calories sky-rocketed leading to a massive increase in carrying capacity for humans.
This sky rocketed further with recent advances in agricultural science such as the Haber-Bosch reaction (sustaining 1/3 of the world’s population which might have a ceiling of 5 billion without it), and reduced death rate from medical improvements, sanitation etc.

This model fits with the Neolithic revolution giving us an explosion in population rate of growth (increased birth rate), and increased population ceiling (albeit unhealthy hordes). As calories increase 2 fold with cooking of inedible plant food, then another 10 to 100 fold by the advent of farming, there is a massive increase in carrying capacity/ population ceiling.

I view evolutionary population dynamics as the competition between a number of these Verhlust curves competing simultaneously, as demonstrated below.

Competing population growth curves

Competing population growth curves

The idea is to view the curves as populations that are all competing with each other. The winners will be the ones who grow the fastest (steepest) and the highest.The light blue line might be a pastoral tribe, and the violet line a cereal farming tribe. The red dashed line would be a hunter gatherer tribe who would be swamped by the others. I would put my money on the light blue and violet tribes in this example.

This perspective takes the view that evolution is a competition for energy. This is something of a contrast to the usual focus of it being a competition among different DNA’s for pre-eminence. Which is the primary competition? You be the judge.

Malthus foresaw a nasty finish in his work- A Malthusian catastrophe (also known as Malthusian check) was originally foreseen to be a forced return to subsistence-level conditions once population growth had outpaced agricultural production. There have been many population catastrophes in history, and many are described in Jared Diamond’s fascinating book Collapse: How Societies Choose to Fail or Succeed. A huge difference between hunter gatherers and Neolithic farmers is that hunter gatherers improve the habitat, whereas farming methods generally destroy it. The oldest clay tablets from Mesopotamia (Stephanie Dalley, Myths from Mesopotamia) include references to wheat farms causing salinity of the soil.

Catastrophes always remind me of Rene Thom’s catastrophe theory which is a straightforward and useful theory that all scientists would benefit from knowing the simple basics of. Essentially when things go wrong in the natural world, it is more like a fall from a cliff than a stroll down a hill. One of the corollaries of catastrophe theory (seems to me) is that by the time it is statistically proven that the catastrophe will occur, it is too late to stop it (think avalanche, broken rubber band, light switch etc). This is why I don’t really get into climate change data- because by the time we have irrefutable evidence, it is too late already to stop it. So if we don’t have proof then it is no comfort to me, and if we do have proof then it is already unstoppable. I think this Leunig cartoon sums it up.


Ubiquities and other chronic confounders

April 6, 2014

When looking at health and chronic disease, there is a never ending confusion. The most powerful yardstick is to find the root cause of a chronic disease. The root cause of most diseases has eluded science thus far, despite intensive research. Therefore we sit in hope, waiting for breakthroughs. Medical science often uses large population studies and powerful statistical methods, however even these methods often fail to produce results. One reason is that they cannot penetrate the smokescreen of common things- we “cannot see the forest for the trees”.

This reminds me of Geoffrey Rose’s classic paper on the limits of epidemiology. Sick Individuals and Sick Populations.  “If everyone smoked 20 cigarettes a day, then clinical, case-control and cohort studies alike would lead us to conclude that lung cancer was a genetic disease; and in one sense that would be true, since if everyone is exposed to the necessary agent, then the distribution of cases is wholly determined by individual susceptibility.”. The moral being that UBIQUITIES cannot be detected by clinical, case-control or cohort studies. This is very noticeable in hypertension research due to the effect of salt- in industrialised countries it is universal/ ubiquitous for people to consume excessive amounts of salt.

In our case of Paleolithic diet- we must realise that Neolithic diet is ubiquitous. Therefore researchers will NEVER identify that it is causative of most diseases, unless they compare to a Paleo eating cohort. Because almost everyone eats a Neolithic diet, this will continually confound researchers.

Just as Dr Rose said regarding a population where everyone smoked, medical research often indicates that certain diseases are genetic when in fact they are are related to the ubiquitous Neolithic diet. For example, suppose that a particular gene gives you absolutely no risk of disease if your folic acid intake is the Paleo intake of the last 2 million years, but puts you at increased risk of disease if you have a lower intake of folic acid, such as commonly found in many Neolithic diets. Some people would say that you have a genetic disease, but it is obvious that it is also a nutritional disease, as with the right intake of folic acid you  are well. This is a gene-nutrient interaction. In this case the gene is not defective, it really is not a genetic disease per se, it is a case where the gene is a risk factor for the illness, the defect is that it is a susceptibility gene. Unfortunately it is probably a similar situation with many alleged discoveries of genes that “cause this” or “cause that”. If a gene puts you at risk of disease if you eat junk food is that a disease or just karma?

The example of folic acid given above in fact refers to one of the most common “mutations” the C677T mutation of the gene which codes the MTHFR enzyme. The MTHFR enzyme is important in the metabolism of the vitamin folic acid. 20% of the population have 2 copies of the “mutation”, and around 1/2 of the population carry one copy (Hardy-Weinberg equilibrium). It is well researched that in populations with a high intake of folic acid, people with this “mutation” are perfectly healthy, but of they live in areas with low folic acid intake, they are at increased risk of diseases such as DVT, pulmonary embolism, stroke, heart attack, spina bifida, and other diseases which can relate to folic acid metabolism. If you carry a mutation of MTHFR, you are one of 50% of the population, or 2 copies, then you are one of 20% of the population.

There are a number of other ubiquities and we should also add to the list chronic infections, some of which are almost ubiquitous.
Lead poisoning- until the massive EPA lead campaign began in 1990, 88% of American children had lead exposure sufficient to be called lead poisoning (and most of the other 12% with levels which have also been proven to have harmful effects). Lead has profound effects on many tissues of the body, via various mechanisms, particularly involving its similarity to calcium and magnesium, such as the important enzyme protein kinase C, and vitamin D. Lead is a known risk factor for hypertension cancer and heart attack.

Trace mineral deficiency, such as iodine deficiency
Glutamate exposure
Salt intake
Cereal
Dietary acid load
Another important group is lifelong or prolonged infection, many of which are very common:

EBV CMV Toxo Herpesvirus family HS HVZ Chlamydia Mycobacterium-tb-avium.
Helicobacter infection
SIBO (small intestinal bacterial overgrowth)

EBV (Epstein-Barr Virus infection, commonly known as infectious mononucleosis or glandular fever) affects around 90% of people by age 30 in urbant populations, and it invades T-cell lymphocytes and remains in them forever, permanently affecting your immune system. Retinol (the animal form of vitamin A, found in cod liver oil, or any other liver or kidneys) knocks out EBV but not many people eat liver or kidneys etc.

CMV (Cytomegalovirus) is a close relative of EBV and is also knocked out by retinol.
Chlamydia is interesting. Around 8% of birds are infected, and have it for life. The more I test for it (pneumonia cases) the more I find.


Beans Means Not Paleo

February 20, 2014

Here in Australia, everyone loves Dr Oz too! Recently Dr Oz interviewed Chris Kresser who is suggesting that dairy, beans and legumes are part of a Paleo diet. This is not so. Chris has just launched his book Your Personal Paleo Code, and we wish him success. Chris is a licensed acupuncturist and has a podcast show Revolution Health Radio which I highly recommend as a very interesting show if you are a podcast fan.

Prof Loren Cordain has written a rebuttal on legumes which outlines all the technical issues why and you can read this here. Beans and Legumes: Are They Paleo? This is a great summary of all the problems with beans and legumes. I also noted his past post about potatoes in response to other enquiries regarding other authors. I have some further comments below.

Like me, you may not have any serious illness (such as coeliac disease) that makes a strict diet necessary. Most of us are eating an UHG diet, that’s my name for an Urban Hunter Gatherer diet. Which means a fantastic diet, but we might slip in the odd glass of wine, chocolate, ice cream or other indulgence. Most people would still call this a Paleo diet, being 80 or 90% Paleo by calories with 10 or 20% palaver (in comparison Joe Average has 25% of diet as Paleo and 75% non-Paleo foods).

Paleo diet is a science, and proud of it. The usual definitions of Paleo are those you will find from researchers like Prof Cordain and Prof Staffan Lindeberg, the two of whom virtually established our current understanding of Paleo. They and their protegees, research teams and students are the source of power behind the explosion in understanding which has taken the world by storm. The correct definitions of Paleo found are in books by Prof Cordain, Robb Wolf and Ray Audette (Neanderthin was the first book outlining the current understanding, after Ray was advised by Prof Cordain, and managed to cure his diabetes and rheumatoid arthritis).

The real Paleo diet does not include dairy, beans/legumes, grains or potatoes. Commentators often compromise and sometimes, and say they are “allowable cheats” and some even go so far as to say that some of these are somehow Paleo. They are not. I suppose people should say “they are not Paleo, but a little bit won’t hurt most of us” (but not those with autoimmune disease or other serious health issues that may be caused by food). As for me, well I just admit that wine and chocolate and cheese and ice cream are definitely not Paleo, but they are less than 10% of my calories, and I am weak at times, and slowly slowly I hope to reduce them.

At least everyone agrees that wheat is not Paleo. Some people say dairy is Paleo- it’s not- a Paleo diet plus dairy is a pastoralist diet, and look where that got Ghenghis Khan- 2/3 of the known world! As for a Paleo diet plus potatoes, well please don’t ask me, I think the humble spud deserves to be humble. And beans and legumes, well sacre bleu! it is just not on.

There are several paths to get to a Paleo diet. The anthropologist path is based on research on hunter gatherers, the archeologist path is based on research on ancient man, or Ray Audette’s test (if was naked with a rock and a stick and no fire, could I have eaten it?) and several others. But one which I discovered early on in my journey (from 1999) and think is very important is the antinutrient test. Antinutrients is the term nutritionists use to describe toxins in everyday foods, probably because toxins or poisons does not sound nice, but that is what they are in every sense of the word. And what amazing toxins they are, with the ability to do tricks that no other known toxins can do, such as turn the immune system crazy.

Real Paleo foods have the lowest level of antinutrients of any nutritious foods. This is why a Paleo diet is the only true “detoxification” diet, all other diets are full of toxins, including most alleged detox diets. This also is why all Paleo foods can be eaten raw- at least in theory, you don’t need to feel obliged to do so. For a long time people ate a lot of foods raw. 10,000 years ago we started to eat toxic beans and grains, when it was discovered that cooking them first makes it possible to survive, though not thrive. Times were tough in those days, surviving was cool, they didn’t need Charles Darwin to tell them that, but the price of short term survival is long term health problems.

The worst sources of antinutrients are beans/legumes, and potatoes. Generally I would say that the worst legume in the Western world is the soy bean, followed by the kidney bean, then all the other beans. Green string beans are 90% husk and 10% seed, and only the seed part is harmful. If you want to know just how harmful some legumes in poor countries can get, read about lathyrism on Wikipedia  and Google Images.

Beans/legumes and potatoes rival wheat for toxins. I regard beans as detestable. I can understand that people who have eaten lots of lentils might miss them. I used to like them myself. Once I went Paleo, I quickly found that I became very sensitive to an upset stomach and general tiredness after eating beans and lentils, so I am glad to stay off them. As for potatoes, my patients with gastroenteritis bugs seem to often link a recurrence to taking some potatoes, and I hope somebody researches that one day.

If you want to eat beans or legumes as part of your diet, that’s your right, but rest assured that it is not a Paleo diet. And they certainly do not pass the antinutrient test.

Chris Kresser has posted a rebuttal to Prof Cordain click here.


Autoimmune disease treatment with the Paleo Diet

February 17, 2014

Autoimmune disease means a disease that is caused by a the immune system behaving wrongly and attacking the body. The proper role of the immune system is to attack viruses and bacterial disease etc.. When the immune system turns on us it is abnormal and this is the cause of many diseases such as rheumatoid arthritis, multiple sclerosis and hypothyroidism. “Officially” the root cause of most autoimmune disease is not known (like most diseases), however there is a large body of scientific literature which indicates that diet can play a critical role in the cause of these diseases.

This has been recognised for many years, as fasting and elemental diets (very purified diets mainly used in research) sometimes cause reductions in many autoimmune diseases. It is now strongly proven in some cases, as people with Coeliac disease are completely better if they are on a gluten free diet, and people with Crohn’s disease or Ulcerative Colitis can often be cured if they are on yeast free diet (particularly if their blood tests showed positive ASCA yeast antibodies). Please note that traditional hunter gatherer diets do not contain the wholesale amounts of yeast found in standard western diets, they only contain the odd small amount of yeast on the outside of certain fruits, like grapes.

Autoimmune disease is very common in modern man, yet very rare in hunter gatherers (whose diet is the basis of the Paleo diet). Research indicates this might be due to differences in diet and lifestyle. Researchers have pinned down many factors in food which affect immunity, and it appears the Paleo diet is low in factors that cause autoimmune disease.

Around 80% of the immune system resides in the gut in order to protect us against infections from our food and water, which until recent years was a major health problem in all countries, and still is a major problem in most of the world. The spleen is the largest immune organ in the body and blood from the spleen is mixed with blood from the gut which then travels to the liver for processing, so the immune system is intimately mingled with everything we eat.

It is also now apparent that immune system is programmed in the gut by a range of factors working together:
– genetic background
– diet (many different effects from diet)
– the presence of bacteria in the small intestine (SIBO= small intestinal bacterial overgrowth)
– the type of bacteria in the large intestine
– whether your gut leaks and how much (leaky gut- particularly small intestine and also large intestine)
– medications
– toxins
– vitamin D status and omega 3 status
– chronic infections such as glandular fever (Epstein-Barr Virus EBV) which permanently infect the T-cells that control the immune system.
– EVERYTHING that affects the gut or diet has implications for the immune system.

So when your immune system malfunctions, there is reason to believe that the malfunction has occurred in your gut, and attention to the above factors may help improve the immune system. Paleo diet addresses several of the factors- dietary proteins, the types of bacteria, SIBO and leaky gut can all be improved.

The Paleo diet has very little in the way of factors that upset the immune system. Whereas modern foods (the Neolithic diet) such as dairy and grains, beans, and potatoes do upset the immune system very directly. Neolithic foods contains toxins such as lectins which can make immune cells malfunction in bizarre ways. It also contains many proteins that were never present during the long evolution of our immune system.

SIBO means small intestinal bacterial overgrowth. The small intestine is supposed to have little or no bacteria, but it has been found that many people have quite a lot of bacteria. This can contribute to autoimmune and other disease. Neolithic food toxins such as lectins and protease inhibitors increase SIBO. The large intestine is the last part of the gut where the faeces is found and it is supposed to be full of bacteria as the large intestine has a different role to the small intestine.

Leaky gut means that there is leakage of gut contents into the gut’s bloodstream through tiny abnormal breaks and holes in the lining of the gut. This occurs in the small intestine in response to many factors (such as gluten, lectins, saponins and other toxins, and to casein) and can also occur to some degree in the large intestine. I also remind people that “leaky gut starts in the mouth” and it is well known that autoimmune disorders have a bad effect on oral health, and conversely oral disease aggravates autoimmune disorders, all types of inflammation and is also a significant risk factor for heart disease. There can be variations in the leakiness of the large intestine which can be improved by diets with more soluble fibre and resistant starch (this increases large intestine butyrate production which reduces the leak in the large intestine).

For abnormal immune cells to cause real problems they need to be stimulated by proteins that resemble our own tissues. Such proteins are found in Neolithic foods, and in  some bacteria in our gut. This is then amplified greatly if the gut leaks as the proteins can come in direct contact with the immune cells, in wholesale amounts. If the gut is not leaky then there is little opportunity for these proteins to come in contact with the immune cells in the blood stream. The leaked proteins can stimulate the immune system to malfunction both by increasing the general degree of inflammation (the amount of activation of the immune system) or by activating specific squads of immune cells that will attack a particular tissue such as bowel, joint or brain to cause a specific autoimmune disease.

High levels of vitamin D and long chain omega 3 “tune up” the immune system to make autoimmune reactions less common and less severe. Long chain omega 3 comes from animal sources such as fish oil and has many benefits, whereas short chain omega 3 comes from such as flax seed oil. It is not recommended to take flax seed oil as it comes with significant amounts of omega 6 fats which are pro-inflammatory and have negative effects on metabolism.

When food upsets the immune system, there are “two sides of the coin”- disease can occur in the gut itself (such as ulcerative colitis or Crohn’s disease), or it can occur outside of the gut (such as rheumatoid arthritis or multiple sclerosis). However in both cases the illness has been programmed within the gut.

Once it goes wrong, the immune system is very sensitive to tiny amounts of food. This is already well known as people who have food allergies can react to tiny amounts of peanut or egg for example. Any every exposure to the wrong food can increase the effect, every single time. This is probably true with autoimmune disease- for example in patients with severe Coeliac disease, a tiny 1/100 of a slice of bread will reactivate it. Therefore if one is to treat the disease with diet, it can only work with strict avoidance of the suspect food. This requires one to follow what is called a “Paleo diet automimmune protocol”.

Epstein-Barr Virus can be knocked out by retinol, the animal form of vitamin A. Plant forms such as beta-carotene can be converted to retinol but this is very inefficient. Retinol is found in high amounts in liver, kidneys and cod liver oil.

Unfortunately what can be done cannot always be undone, therefore there is no guarantee of success with diet. However, remember that we all have to eat, so why not eat the best possible diet? Also to remember that you can combine the Paleo Diet with your normal medical treatment, so they work together as a club, not in competition with each other. If you do respond to dietary therapy, there is good reason to believe that it will give you many additional health benefits as well as treating the disease you are focusing on.


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