Thursday, November 17, 2011

What does a bailout mean for a saver

People save money. The banker uses that money to loan it in good or bad schemes. Lately it has been mostly bad, because there is too much money, and good schemes are always rare. The money is gone, and the bank owes money it doesn't have to the people. The government comes and creates some money out of thin air and pays to the bank. They can do that because it is made of bits, and bits cost nothing. The overall value of the money reduces. So ultimately the money comes out of the pocket of the people that saved, because it is that money that got devalued.

Now the bankers give themselves a big pat on the back for the mess that they created and then pay themselves large bonuses, and so more money goes down the drain.

Meanwhile the value of the money has gone down so price of everything rises.

The USA is in a very interesting situation, because the world uses their money. So when they print money, everybody who saves money, doesn't matter where they live pay for the bailout.

They are going to print again by end of nov or early december. They are short by 2.1 trillion. Your savings will become smaller again.

The only way is to get out of the system. Don't save in the fiat currency, save in commodities or companies that you know are actually sound.

Gold has been performing much much better than the stock market over the last 5 years. Gold/silver are the best commodities for investment.

Tuesday, November 15, 2011

How to defend Low carb for diabetes with a doctor

Diabetes is the disease of the body's inability to bring down glucose levels post meal.

The hormone that is responsible for bringing the glucose level down is insulin.

There are two types of diabetes.

In Type1 diabetes the body has an impaired ability to create insulin in required quantities. This occurs normally due to an auto-immune condition where the body's immune system is somehow primed to act against beta cells (insulin producing cells) in the pancreas. In this case there may be a requirement to get insulin externally.

In Type2 diabetes the body is not responding to insulin. The condition is called insulin resistance. There are two versions of insulin resistance. One where the insulin receptors on each cell has a defect due to which it cannot respond to the insulin. Second where the cell is so replete with fuels that it modifies itself to become resistant to insulin.

The first condition is very complex and requires gene reprogramming (via epigenetics), which is possible but very slow, and takes a long time. An evolutionary diet based on food groups eaten around the time Homo Sapiens evolved is highly likely to help.

The second condition is simpler and requires calorie restriction. The condition may become complex if mitochondria (the power generators of the cells) are damaged due to excess fuels. The reduction in mitochondria is generally a genetic susceptibility and the damage is difficult to undo. Most fat people have this condition.

So if the condition is simply excess fuels then calorie restriction will help the problem. But this condition rarely reaches the diabetic stage without more complex problems occurring like insulin receptor damage or mitochondria damage.

When we have diabetes, the real and most obvious symptom is that glucose levels stay higher. The most obvious solution is to keep the glucose in the diet low (low carb), so that the body needs to deal with less glucose.

But this advice is never given by the doctors.

There are several reasons for this.
1) Low blood glucose level can be a fatal condition, while high blood glucose levels kills slowly. Advice to eat low carb invites law suits if the patient is not careful of his health, and dies due to negligence.

2) Maintaining glucose levels through diet is not a profitable business. The insulin manufacturers resist any publication of research papers, which show benefits for low carb diets. Almost all of the low carb friendly research is done outside the USA, restricted to a very few countries.

3) Until very recently, it was not possible to measure blood glucose very frequently. Which makes it difficult for the patient to be aware of the symptoms of low glucose and high glucose. This made low carb possibly a dangerous solution.

4) There has been a widespread campaign against saturated fat and cholesterol, this makes a prudent low carb diet also low in fat. The patient must eat something, proteins are not very good fuels, and they also provide fuel by converting to glucose, which again raises blood sugar. Since the doctor cannot recommend eating more fat, so they don't recommend low carb.

The first problem can be mitigated if the patient takes responsibility of his/her own health. Low carb is the healthier option in the long run. Dr. Bernstein has been living with it for the last 65 years.

The second is really an information restriction problem, and affects doctors providing care to the patients. They are not able to provide adequate information to the patient.

The third problem is mitigated by frequently measuring blood glucose using the cheaply available glucose meters. It is painful, but very effective for understanding how body responds to different foods, and how low or high blood sugar affects mood and feeling of general well being.

The final problem, is the real problem, when it comes to convincing a doctor or a patient to move to a low carb diet. Although there has been a lot of evidence that saturated fat and cholesterol are not a problem, but there has been no real conclusive evidence for them. The situation has changed since last year for saturated fat. The best known nutritionists have published a consensus paper in favor of saturated fats.

Even google has become very helpful in this regard. I found all of the research references in this article on the first hit when searching for "saturated fat research papers".

Before we get on with the articles and research papers I should explain what I mean by a prudent low carb diet for a diabetic person.

The diet should be tailored based on ones individual blood glucose level, and his/her individual response to different foods. Any food that raises blood glucose level an hour to two hour, or in some special food cases (so called low carb pasta) upto six hours later beyond 140mg/dl should be avoided or reduced so much that the blood glucose does not go beyond this level. It is known that all kinds of problems occur when blood sugar moves beyond this level.

A patient must count his/her carbs when eating so that they can maintain a tight control on the blood sugar levels. For a diabetic generally this means carb count below 100gms, and possibly below 50gms during the initial stage. Note only carbs and sugars are counted, not fibers. Fibers do not convert to glucose and have no contribution towards glucose. They are infact cause an increase in the requirement of glucose and may take a long time in digestion. This may cause persistence of high blood sugar levels for highly resistant people. This is called the chinese restaurant effect by Dr. Bernstein.

Being on medication poses certain problems with low carb diet. The diet itself is designed to lower blood glucose levels. When we factor in the glucose lowering medication, there is an obvious need to lower the medications. This must be done very carefully. It might be prudent to just let the blood glucose level go high, instead of risking too low glucose level. This is particularly important with insulin. Again it depends on the level of medication. One cannot just drop their medication, without considering very carefully what happens without the medication.

A patient is generally over loaded with glycogen (the storage form of glucose), before starting a low carb diet. The initial very low carb period helps in getting rid of this extra glucose, otherwise it gets difficult to get control of the glucose levels.

It is very difficult to reduce the carbs abruptly. There may be some sense in slowly reducing carbs, but this will delay recovery. So the transition should be as fast as possible, but don't over do it, and be extremely careful with medications.

A low carb diet is necessarily high in fats. Carbs and fats are both fuels for the body. For a diabetic Carbs are no longer acceptable fuels, so fat must take its place. Unfortunately constructing a low carb diet based on plants only is difficult, as they are all based on carbs. Coconut oil/ghee, fibrous vegetables, nuts, cheese and avocado help, but are not entirely sufficient. And the carbs do add up. It is very difficult to digest large quantities of fiber. Even milk is too high in carbs.

It does require eating a fair amount of eggs and fish/meat/chicken to supply the fuel the body needs. Effort should be made to keep the quantity of protein due to meat low, to keep glucose levels due to protein in check. A low carb paleo diet or the ketogenic version of the Perfect Health Diet is ideal.

Once good blood glucose level is achieved then efforts should be made to very slowly raise carb levels to check if the insulin sensitivity is returning. There is no point in staying at a very low carb level when the insulin sensitivity has returned. This is the recovery phase. Several supplements help, but they are not in the scope of this article.

I think the following article and the following lecture cover the issues very well for a layman.

Truth about Saturated Fats - It is jointly written by Dr. Mary Enig and Sally Fallon founder of Weston A Price Foundation. The Truth About Abs is a website were I first learnt the principles of dieting and exercise.

Episode 17: Saturated Fats, Cholesterol and Cardiovascular Disease - This audio clip is slightly higher level than the first article, but covers a lot more ground than the article. A list of bullet points are provide to guide through the material in the clip.

The following papers should be very convincing to a doctor. They are fairly recent, only one year old. These should be printed and important points highlighted, and then presented to the doctor. They will either convince the doctor, or you will know if the doctor is interested in your health. That last thing is very important to know before you trust your health in his/her hands.

A meta-analysis evaluating evidence for or against saturated fats. This paper was instrumental in shifting the opinion in favor of saturated fats. Ronald Krauss has been at the forefront of research on cardiovascular disease, when he says saturated fats are not to blame people listen.

The consensus paper already mentioned, does not go very far, but remember this is a consensus paper, and it takes a while to build consensus. It still is very neutral to saturated fats, and says that it is likely that other factors in the foods containing SFA may be to blame. This is a large change in stance. This paper at least exonerates coconut oil, if not ghee. As Coconut oil is free of cholesterol, and contains Vitamin E, it should become acceptable to doctors, based on this paper.

There are a couple of papers, which show that milk and its products are actually inversely related to cardiovascular diseases and diabetes.
Unfortunately the text of the first paper is not available for free. But the two papers exonerate ghee and other milk products from blame for heart diseases and diabetes both.

Unfortunately I don't have any such clear papers and as easy to find in favor of cholesterol. Suffice to say that the liver creates almost all of the cholesterol even for heavy meat eaters, so its not like the cholesterol in food impacts cholesterol levels. There is evidence that it is so, but not very clear to point out.

Thursday, November 10, 2011

How to meet the protein requirement for a vegetarian

The good thing is that not much protein is required.

Read the protein debate between bodybuilding coaches, Dr. Stuart Phillips and Dr. John Berardi.

Studies have shown that <0.6gm/kg/day is required for an athlete to maintain lean mass. For non-athletes protein requirement increases but is within .8gms/kg/day. Remember the weights are Lean Body Mass, ie minus fat, because fat doesn't need much protein for maintenance.

Lets take as an example a 80Kg male with 25% body fat. The lean mass would 60Kgs. At .8gm/kg/day it will be 48gms per day.

Assuming you eat only vegetables, but not much fruits. Fruits contain around 5% protein while vegetables contain 10% protein calories. Some vegetables like green vegetables are quite high, but they are not absorbed as well.

With legumes the protein ratio can be increased. But they are not complete proteins and combining with grains the protein ratio comes quite a bit down. A bowl of cooked sprouted mung per day would not be a bad thing.

There is a limit on how much fiber can be handled by the body. This puts a limit on how much fibrous vegetables can be eaten. But there is no limit on very low fiber foods like potatoes. Potatoes provide 10% protein and are a complete protein source.

Now for getting enough protein ie 50gms from a diet which has only 10% protein calories, you need 2000kcal. 10% of 2000 will be 200, which is equivalent to 50gms. This is not much.

This is how people lose weight and stay healthy on a potato only diet. There have been experiments in the past with a few people doing this for a year. Note sweet potatoes may not fare so well, because of their extra fiber. On the positive side Potato has balanced protein. There have been some native populations which ate tubers all year round and provided 90% of their calorie source, with occasional meat addition. Some others had as much as 80% of coconut, with small amounts of fish.

This is not so bad for losing weight also, if you can increase the energy expenditure to beyond 2500kcal, this should be trivial for most people with 80kg weight.

For gaining muscles, research has shown that 1.4gm/Kg/day provides maximal growth in muscles. This equates to 3500kcal/day of zero fat food. Adding some fat will take it beyond 4000kcal. The important point is that we don't need to grow muscles at a very fast rate. We can be patient and live with a less than maximal muscle growth.

Think how much protein you need to add 1 kg of muscle. The muscle is mostly water. It will have about 250gms of protein and if you gain it over a month you need on an average 8gms more. 1Kg lean mass gain in a month is pretty good and difficult to attain. Research shows that at best to utilize 8gms of protein you actually twice that in diet. Assuming a more conservative 4 times, we need 32gms more protein per day. Also since the 48gms we calculated before is actually an over-estimate for an athlete, it will go down to (based on the .6gms) 36gms. Total requirement will be around 70gms. This is equivalent to 3000kcal. It is quite easily achievable on a low fat vegetarian diet.

You do need to do more exercises to build muscles which requires a lot more energy. This is where ghee and coconut oil can add support. It will be slower than what it could be on a higher protein diet, but its not out of reach.

You can add whey protein to help further, but it is not necessary. You can also add lots of milk and yogurt, if you can handle it. Milk has some Insulin like Growth factors (IGF1) which help gain muscle. This is why GOMAD (Gallon of milk a day) strategy is very popular amongst body builders.

As an example see Sushil Kumar a pure vegetarian was bronze medalist at Beijing Olympics.

I do understand that there will be some people so damaged that this will not be enough, and they will need special additions like whey.

Another Caveat. Pure vegetarian diets require milk for purposes other than protein. Vitamin B12, Zinc, and K2. So think very hard if you are milk intolerant and are vegetarian. Vegan diets are not for humans. Another caveat is that it is very difficult to get good quality milk. This last factor does not allow vegetarian diets to provide complete health benefits.

Tuesday, November 8, 2011

What is a healthy diet

I believe that a healthy diet is one which maximizes nutrients and minimizes toxins.

So we have made a few assumptions here.
1) We eat food for the nutrients in it.
We have a more or less fixed need for body building nutrients, based on body composition. The variation is mostly due to various health factors. While the need for energy giving nutrients varies wildly based on activity levels. Excess of some nutrients can be harmful, this depends on the ability of the body to excrete them.
2) Foods can also contain toxins in them.
Small amounts of toxins can be good, via hormesis. The healthy limits are small for toxins. The toxins can be neutralized by the body (liver), but there are strict limits to them.

It is important to determine bioavailability of nutrients before saying that a particular food group has nutrients. And we should always compare density of nutrients with energy in the food. There is no point comparing 100gms of wheat with 100gms of spinach, because you will get very little energy from spinach, so you can eat a lot of it without overeating. Although there are other constraints like fiber, and excess of nutrients.

It is also important to understand that almost all toxins are proteins. Proteins are what our body reacts against. The whole immune system is geared against those. Non-protein toxins can be very bad because the body will not know how to react to them.

What is very low in toxins? It is animal meat. Why? Ever tried to give aspirin to a cat. These are obligate carnivores, and do not have the genes to process toxins. Why did they evolve like that? Because they eat only meat, and have no need to process toxins. If you find a cat that eats plant material, you will find that it is domesticated and that it is sick. This does not say that animals cannot produce toxins, some do to use as offensive weapons. The toxin is harmful to the animal itself and so is contained in a well protected gland.

The belief that saturated fat and cholesterol is harmful is a belief that is rested upon the belief that mother nature is crazy. That it would actively store a harmful ingredient for future use. Most of the body stores of fat are saturated(SFA) and mono-unsaturated(MUFA). There is enough fat to last a few months, if there is no other calorie intake. Contrast it to the body's store of Glycogen (glucose + water). It lasts only more than a day, when a lot of energy use is obtained from fat. Why did body store SFA and MUFA instead of Glucose? The reason is that SFA and MUFA are very stable, they do not react easily and hence can be stored safely, while Glucose is highly reactive. So much so that glucose is not stored as glucose, but as glycogen. The other equally important reason is that the energy density of SFA and MUFA is quite a bit higher than glucose. In fact twice more than glucose, if glucose was not stored with water. Glycogen is not anywhere comparable. The body only stores longer chains (>16), because they are more stable and more energy dense, the lower chains are converted to ketones and used immediately.

If you find a research that shows that saturated fat is bad, you will find that the study is observational, where the people eating saturated fat also indulged in several unhealthy practices like smoking, eating manufactured, heavily processed food, abusing alcohol, no exercise, etc. You may also find that the researcher treated saturated fat and trans fat (a very harmful unsaturated fat) interchangeably, or that the research says something else while the abstract and summary says something else. There are so many ways to lie in nutritional research, for getting the almighty grants.

Fat is required to process fat soluble vitamins, E, A, D, K. What remains is B and C, and we think fats are useless. Check out what happens to people with gastric bypass surgery. They exchange their obesity with multiple fat soluble vitamin deficiencies. Of these only E comes from plant sources. Others are obtained from animal sources. D can be made internally from the sun. A and K can be made internally from plant sources. Some people cannot make sufficient Vitamin A, and most people cannot make sufficient vitamin K2. I am sure many doctors would not have heard of Vitamin K2, such is the state of medical science. There is a reason why Milk needs to be fortified these days, because the fat has been removed which contained those vitamins. Low fat milk needs to be enriched, but in the absence of fat, useless water soluble plant forms are put in it, just to claim that it is more healthy.

Many doctors do not know that Vitamin K2 is crucial to proper calcium utilization, in strengthening of bones and teeth. Have you heard very old people say that they have strong bones because they ate a lot of ghee in their childhood. Do you know the food that is very high in Vitamin K2? It is ghee from a grass fed cow. Only Natto and Aged Cheeses have higher K2 concentration. That generation is already gone. If you did hear it you would have heard it twenty years ago, when some of them were alive, after living 90 years. Since the last 50 years we have been eating manufactured oils. First it was hydrogenated fats, now they are refined oils. And we think that we are doing something healthy :-).

This does not mean that we should eat a lot of fat by itself, as it is also mostly empty calories. But foods that contain fat, also contain nutrients that are delivered by the fat content. Removing their fat makes them less complete, and harmful.

Cholesterol is created by the liver for several purposes, including immunity, upkeep of arteries, shuttling nutrients. There is no such thing as a bad cholesterol, only healthy or unhealthy cholesterol. A healthy LDL is not a bad cholesterol. An unhealthy cholesterol is bad, doesn't matter whether it is LDL or HDL. Why does it become unhealthy? Does diet have anything to do with it? Does oxidization of cholesterol has anything to do with it. Cholesterol are lipoproteins ie compounds of fats and proteins. So what kind of fat gets oxidized faster. Is saturated fat more easily oxidized or poly unsaturated fats? That is a basic chemistry question and anybody with a Pre-College level Chemistry should be able to answer this. Vit D is all the rage these days, but how does the body produce it without cholesterol. What are all the hormones made up of if not cholesterol. What about Neurons and Brain, much of it is Saturated fat and cholesterol, yes Omega3's also feature strongly.

OK enough about meat/saturated fat/cholesterol.

Lets talk about vegetables and fruits. We have already established that they have toxins. Does it mean we should not eat them? No, we are omnivores, this means that our body and the liver is able to handle toxins. Actually it is important to exercise the ability to handle toxins. It is like exercise. The exercise causes stress to the system, which forces the system to adapt, leading to a better health state. Similarly eating the optimum amount of toxins is healthy for us. There will be a J curve here, with less causing problems and an excess also causing problems. So the toxins within limits are not a problem. Vegetables and fruits also provide us with micro-nutrients that are very difficult to get from animal foods. This is why it is very important to eat them. Fiber is also one of the nutrients.

It is a myth that all kinds of fiber or a lot of fiber is good for us. Fiber provides food to the gut flora, which produce B and K vitamins and short chain fatty acids. The Short Chain Fatty Acids (SCFA) are very important for the gut health. What kind of fiber will be acted upon faster? The soluble type, and that is the type which is more healthy for us. Insoluble fiber is known to damage the gut lining, instead of helping it. Indeed vegetables and fruits are very rich in soluble fiber. Also fiber binds nutrients, so it is important to completely digest them, to get at those nutrients. There is a limit to how much gut flora our intestines can accept, and consequently how much fiber we can digest. We are not apes or cows.

Now lets get to the last type of food, grains and legumes. What kind of nutrients do we get from whole grains that we don't get from meat and vegetables/fruits? None, no such nutrient exists. If anybody can think of something please tell me. Are grains more rich in nutrients than meat and vegetables/fruits? Please compare them and get back to me if you find any grain which is more nutritious. Please do check the bio-availability of nutrients in grains, they are pathetic. Read about the discovery of vitamins, and how they were cured. They were all caused by deficiencies due to not eating meat, vegetables and fruits. They were never caused because of not eating grains or legumes.

The current belief in the healthiness of whole grain or rather whole wheat was manufactured by the USDA, whose mandate is to sell agriculture products. Nobody noticed the conflict of interest when they assigned them the task of defining the nutritional policy. Remember whole grains has only been compared with refined grains never with the absence of grains.

Yes, we can also improve the bio-availability of nutrients in grains and reducing the toxins in grains by processing them in certain ways. Soaking, grinding, filtering, fermenting, and cooking. Anybody remember how grains were handled in traditional times. We used to get our wheat, wash them in the water, dry it, then get it ground. Before making the dough we used to use a sieve to filter the bigger parts and cook the dough. We did not do the whole process that Europeans did because wheat has not been in widespread use in India for a very long time. Europeans additionally ferment it with yeast. South Indians do the same process to most of their grains and eat dosas/idly's made of these things.

Cooking is used to increase the bio-availability of nutrients in all kinds of foods. It is not just for the taste and texture. Fermentation is the second most useful processing technique for increasing bio-availability.

In older days people did not eat new foods everyday. They had very few staples and ate them day in and day out. The food was more related to what grew locally and changed seasonally. We do not need to eat a lot of variety everyday. Its actually better to eat same food everyday, because it keeps the food reward low, and prevents over eating. Varying food seasonally provides the variety without increasing food reward, and overeating. The body holds nutrient stores, which last typically around a year. Some critical nutrients like B12 are held for even 40 years. Some nutrients must be replenished on a daily basis, some of these are B vitamins, Vit C, and electrolytes. Vit C requires that we eat fresh raw fruits and vegetables. B Vitamins require that we keep out gut bacteria healthy, which requires eating pro-biotics and pre-biotics, fermented foods help here. Electrolytes and other minerals are best absorbed from cooked foods, which breaks down cell walls releasing Potassium and other intra cellular minerals. Boiling is probably the best way of cooking food. It is important to have raw, cooked, and fermented foods everyday. That is probably the reason for the ubiquity of pickles in all traditional cultures.

Richard Feynman once gave a lecture on the question "What is Science?". He defined science as follows

Science is the belief in the ignorance of experts.

So I have a question to the people brave enough to wade through all of this. Are you ready to question the ignorance of your nutritionists? This is how science works and your health depends on questioning this absurd status quo.

1) Avoid manufactured fats, and instead consume natural ones (Ghee/Coconut oil/Olive Oil/Mustard Oil).
2) Removing natural fats from foods is harmful.
3) Eat meat, it is good for you. Avoid meat from factory farms (mostly chicken).
4) Eat Vegetables and fruits, they are good for you. Avoid vegetables that give you problems of gas. You may not be digesting its fiber or toxins well.
5) Keep the consumption of grains/legumes low. Do not depend on them for nutrients. Process them well to make them more nutritious, and reduce their toxins.
6) Cooking is important.
7) Raw foods are important.
8) Fermented foods are also important, the ones with live bacteria, not the ones with Vinegar.