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.
Tuesday, November 15, 2011
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.
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.
Summary
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.
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.
Summary
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.
Friday, February 11, 2011
Hyderabadi Katchi Biryani
The Katchi means raw. The raw mutton is cooked very slowly with partially cooked rice for around an hour.
The recipe requires about 1 Kg of fairly large pieces of lamb. The meat must not be very tough, because we don't want to overcook the rice.
The meat is first marinated with ginger garlic paste with some tenderizer for maybe two hours. The tenderizer is not absolutely required if the meat is not tough.
Next cut 1/2Kg onions in slightly thin half circles, and fry it in butter or ghee, till crispy. You will need to add salt to it.
Put half the fried onion along with assorted whole spices (necessary are black (large) cardamom, cloves, and black pepper, as these give a hot flavor. You can also add cinnamon, green cardamom, star anise, if you want a more subtle and softer taste) into the marinated meat. Also add two spoons of coriander seed powder, 1 spoon caraway seeds AND 1 spoon caraway powder in the mix.
Add some green coriander, and green mint leaves.
Also add 2 cups of hung yogurt.
Lastly add some green hot chilli, depending on the sharpness you want.
Also add some red chilli powder for colour.
Also add salt to taste.
Mix all the above in the meat and leave it for further marination for another couple of hours.
Now take 300gms rice (the original recipe called for 1/2Kg, but I prefer the more oily biryani, and lower carb), and keep it in water for soaking. The rice should ideally be a good quality basmati. The basmati rice does not get sticky, it does not break easily, and has a unique smell of its own. It is also a long grain rice which gives a good texture to the biryani. Leave the rice for an hour for soaking, with adequate salt.
Take some of the assorted whole spices used in the above mix fry them in ghee, and pour it over the rice. Don't use butter here, as it will heat to very high temperatures unlike frying onions. This step can be done before the frying of onions, so that the onions will take any extra cumin left in the ghee.
Then boil the rice, till it starts to increase in size. Let it boil for another minute, while mixing it, so that the oil get coated over the rice. Drain out the water and cool the rice with fresh water. We don't want the rice to cook any further. The logic is that the rice cannot start to cook without boiling in water, so this step is important.
Now take a very heavy bottom pan with a very heavy lid. Basically we want some pressure to build in the pan. A pressure cooker would be the ideal device. Put the meat at the bottom of the pan. You have to judge the fat content of the meat. If it is too lean add some butter or ghee to it, otherwise the biryani will come out too dry. You might have to experiment on this aspect. If you don't mind more fat like me then start with more ghee and reduce subsequently.
Over the meat add the half boiled rice, with its own spices. Mix some Saffron in a small amount of milk and pour over it. You could also use turmeric in place or in addition. It makes some rice coloured and some white, giving a nice texture to the biryani.
Now add some more green coriander leaves and mint leaves, and the remaining fried onions over it.
Now cover the pan and cook on a slow heat. Some sort of insulation is required to avoid pressure escaping from the sides of the cover. Traditionally wheat dough is used.
In the beginning the heat can be higher, but once the temperature is attained, the heat must be low.
The temperature is easier to judge with a pressure cooker, just let it build some pressure but not enough that it comes even near to giving a whistle.
After about an hour of cooking, the biryani is ready. The time also depends on whether you started with a high heat or whether the meat is tough. Don't exceed one hour, otherwise the rice will be overcooked. This is why you need meat from a smaller goat. If you don't mind the rice getting overcooked then it is OK. A good quality basmati will not look bad even after overcooking.
The Rice in biryani is cooked from the moisture in the meat and yogurt. There is no water added. You will find that the rice by itself tastes heavenly.
If the meat is not tough and the temperature used is correct then the meat will come out very tender, and juicy.
You will have to mix the meat, fat, and rice, as the rice will be sitting over the meat and fat, before you serve.
For a video look at the following.
http://www.youtube.com/watch?v=WOvFCGjGp1A
The recipe requires about 1 Kg of fairly large pieces of lamb. The meat must not be very tough, because we don't want to overcook the rice.
The meat is first marinated with ginger garlic paste with some tenderizer for maybe two hours. The tenderizer is not absolutely required if the meat is not tough.
Next cut 1/2Kg onions in slightly thin half circles, and fry it in butter or ghee, till crispy. You will need to add salt to it.
Put half the fried onion along with assorted whole spices (necessary are black (large) cardamom, cloves, and black pepper, as these give a hot flavor. You can also add cinnamon, green cardamom, star anise, if you want a more subtle and softer taste) into the marinated meat. Also add two spoons of coriander seed powder, 1 spoon caraway seeds AND 1 spoon caraway powder in the mix.
Add some green coriander, and green mint leaves.
Also add 2 cups of hung yogurt.
Lastly add some green hot chilli, depending on the sharpness you want.
Also add some red chilli powder for colour.
Also add salt to taste.
Mix all the above in the meat and leave it for further marination for another couple of hours.
Now take 300gms rice (the original recipe called for 1/2Kg, but I prefer the more oily biryani, and lower carb), and keep it in water for soaking. The rice should ideally be a good quality basmati. The basmati rice does not get sticky, it does not break easily, and has a unique smell of its own. It is also a long grain rice which gives a good texture to the biryani. Leave the rice for an hour for soaking, with adequate salt.
Take some of the assorted whole spices used in the above mix fry them in ghee, and pour it over the rice. Don't use butter here, as it will heat to very high temperatures unlike frying onions. This step can be done before the frying of onions, so that the onions will take any extra cumin left in the ghee.
Then boil the rice, till it starts to increase in size. Let it boil for another minute, while mixing it, so that the oil get coated over the rice. Drain out the water and cool the rice with fresh water. We don't want the rice to cook any further. The logic is that the rice cannot start to cook without boiling in water, so this step is important.
Now take a very heavy bottom pan with a very heavy lid. Basically we want some pressure to build in the pan. A pressure cooker would be the ideal device. Put the meat at the bottom of the pan. You have to judge the fat content of the meat. If it is too lean add some butter or ghee to it, otherwise the biryani will come out too dry. You might have to experiment on this aspect. If you don't mind more fat like me then start with more ghee and reduce subsequently.
Over the meat add the half boiled rice, with its own spices. Mix some Saffron in a small amount of milk and pour over it. You could also use turmeric in place or in addition. It makes some rice coloured and some white, giving a nice texture to the biryani.
Now add some more green coriander leaves and mint leaves, and the remaining fried onions over it.
Now cover the pan and cook on a slow heat. Some sort of insulation is required to avoid pressure escaping from the sides of the cover. Traditionally wheat dough is used.
In the beginning the heat can be higher, but once the temperature is attained, the heat must be low.
The temperature is easier to judge with a pressure cooker, just let it build some pressure but not enough that it comes even near to giving a whistle.
After about an hour of cooking, the biryani is ready. The time also depends on whether you started with a high heat or whether the meat is tough. Don't exceed one hour, otherwise the rice will be overcooked. This is why you need meat from a smaller goat. If you don't mind the rice getting overcooked then it is OK. A good quality basmati will not look bad even after overcooking.
The Rice in biryani is cooked from the moisture in the meat and yogurt. There is no water added. You will find that the rice by itself tastes heavenly.
If the meat is not tough and the temperature used is correct then the meat will come out very tender, and juicy.
You will have to mix the meat, fat, and rice, as the rice will be sitting over the meat and fat, before you serve.
For a video look at the following.
http://www.youtube.com/watch?v=WOvFCGjGp1A
Sunday, December 26, 2010
High Blood Pressure and Heart Disease
One of my friends has a high blood pressure, which he gets sporadically and has dizzyness as an indication.
High Blood Pressure has a good short term solution, drinking beet root juice. It works by providing a high dose of nitrates. The nitrates convert to Nitric oxide and then to nitrous oxide. Nitrous Oxide dilates the arteries and results in decreased blood pressure. Nitrates are present in large quantities in leafy vegetables including spinach. Some vegetables will have more nitrates and others less. Beetroot is one of the highest in nitrates.
The real problem is the long term one. High Blood pressure generally indicates bad and constricted arteries, which leads to heart trouble.
My friends cholesterol is a bit higher, but that in my opinion is not a problem. In my opinion its not high enough ;-). It should be 200-240 according to this graph.
http://freetheanimal.com/images/2009/09/cholesterol-mortality.gif
His problem is triglycerides, which are very high, more than 200. As soon as these drop the cholesterol level will become normal.
Reducing triglycerides is very easy. They are directly related to carbohydrates. Reduce carbs and trigs will drop. Just for experiment you could eat a very low carb (< 50gm) high fat diet in the night and get your blood tested in the morning, you will find that the trigs have dropped, from your previous reading.
But that is not the real problem. The real problem is the calcification of arteries, which I am suspecting.
To find out how much of your arteries are calcified, you need to take a test called coronary calcium scoring.
It takes a special X ray to determine how much calcium exists in the arteries.
If indeed calcium score is high then you need to take several steps to get rid of it.
If you talk to a doctor they will say that it cannot be reduced. But it indeed can be reduced.
We have to understand first why calcification and coronary plaque happens.
There are several individual problems involved in heart disease.
1) The arteries get damaged. There may be several reasons for it. One is copper deficiency, another is microbial infection. Microbial (Chlamydophila_pneumoniae) infection will cause plaque buildup on its own.
http://wholehealthsource.blogspot.com/2010/04/copper-and-cardiovascular-disease.html
The microbial infection is possibly one of the major causes as the anti-bodies to this bacteria are higher in most people with heart disease.
2) If you have lots of small dense LDL, they have a tendency to get oxidized and get stuck into the damaged arteries. Then macrophages (white blood cells) get stuck to it trying to remove them. This causes plaque buildup.
http://en.wikipedia.org/wiki/Low-density_lipoprotein
3) Arterial Calcification is highly correlated with Diabetes, so much so that it is listed as the highest risk factor.
http://en.wikipedia.org/wiki/Atherosclerosis
Diabetes is the end stage of Insulin resistance. It is important to reduce insulin resistance to prevent arterial calcification.
4) Normally Calcification and Plaque buildup don't cause any problems if you don't get blood clots also called thrombosis. It is important to prevent clotting of blood.
http://en.wikipedia.org/wiki/Coronary_thrombosis
We have to attack each of the above to cure the heart disease.
1) Checking for Copper deficiency is difficult.
http://wholehealthsource.blogspot.com/2010/04/copper-in-food.html
You can see that potatoes are very good source for copper. But liver is the best. Some liver every week could be helpful.
2) To deal with bacterial infection it is important to increase your Vitamin D level to a good level from 40-80ng/ml. Use sun bathing. Use cod liver oil, or use vitamin D supplements but get this done. It is easy to get the Vitamin D test done in India. In Bangalore it costs 900/-. Be careful as some people with calcium regulation problems are not able to have a high vitamin D level. Hyperparathyroid or CKD may be suspected. Levels of upwards to 200ng/ml have been found in healthy individuals. 40ng/ml is the minimum acceptable level, but in lab ranges it may be the max level, because most city dwelling people are highly deficient. The ranges are based on people being tested which are all sick people from metros.
http://www.vitamindcouncil.org/
3) To reduce LDL Oxidation and to prevent calcification you need to reduce carbs in the diet. Reducing carbs reduces small dense LDL which prevents plaque formation.
http://cholesterol.about.com/od/lipoproteins/a/smalldenseldl.htm
Reducing carbs will also keep insulin low which should prevent further calcification.
We need to have energy. There is only so much protein a person can eat. If we reduce carbs, we need to increase fat.
4) The Calcification can be reduced by increasing intake of the Vitamin that is responsible for proper calcium utilization. The Vitamin K2.
http://wholehealthsource.blogspot.com/2008/11/can-vitamin-k2-reverse-arterial.html
It comes in two forms MK4 and MK7. The MK4 is the most effective vitamin but is very short lived. The MK7 is less effective but remains in the body for a much longer time. It can also get accumulated for later use. Vitamin K2 can also be utilized for other purpose where Vitamin K1 can also be used. Since it is difficult to get lots of K2. It is good to eat more vitamin K1.
Source of Vitamin K1 is Green Leafy vegetables.
Source of MK4 are milk, eggs and meat. Pastured Ghee is the most concentrated source of MK4.
Source of MK7 are fermented and aged cheeses like gouda, parmesan, etc.
5) Very important is to prevent clots in blood. It has been shown that higher Omega3:Omega6 ratio prevents clots in the blood. Inuits and other arctic dwellers who eat a lot of fish have a much higher omega3:omega6 ratio and had bleeding problems due to lack of clotting. They have a lot of coronary plaques and calcification but never get any heart problems because of this issue.
Our own diets are very high in Omega6. This causes the blood to clot sometimes. We need to balance the ratio to make sure that we don't have blood clots. There is a medicine called warfarin that is used to thin blood. But it works by blocking the action of vitamin K2. The K2 paper above used warfarin to induce calcification in rats.
The best option is to increase O3:O6 ratio in your body. You cannot test for it. It also takes a very long time in years to actually overturn the level, as the ratio is at the cellular level. But it must be attempted by reducing all high O6 sources in foods and increasing O3 sources. That is why I recommend to avoid refined oils which have higher than 10% O6. Try to calculate and add enough O3 to get nearer to 1:1. 1:2 would be OK but don't go below.
When increasing fat for reducing carbs this problem becomes much more acute. It is important to eat only fats that are very low in Omega6. The best oils are Ghee (<4%) and coconut oil(<2%), which are very low in Omega6. These have a lot of saturated fat, but contrary to popular belief saturated fats are very healthy. They are the most stable fats. Our body can desaturate them as it needs. They are the forms that our body creates from carbs. So fearing them is pointless. Even after eating lots of fats and meat for more than a year I have not been able to increase my dismal (<150) cholesterol.
Low O3:O6 ratio is also very closely related to heart disease.
http://wholehealthsource.blogspot.com/2009/05/eicosanoids-and-ischemic-heart-disease.html
http://wholehealthsource.blogspot.com/2009/05/eicosanoids-and-ischemic-heart-diseas.html
6) Avoid wheat. It is very much related to heart disease. It affects in two ways. First it is known to reduce Vitamin D3 levels in the body. Secondly it is also known to increase insulin resistance. Which forces the body to increase insulin levels.
http://rawfoodsos.com/2010/09/02/the-china-study-wheat-and-heart-disease-oh-my/
The data from China Study implicates Wheat. More than 60% relation between the two and with a better than 99.9% probability of the relation being true. This is a big deal.
7) Avoid Sugar. It is also very much related. The problem is mostly due to the fructose component of sugar. It affects insulin resistance directly.
http://www.sciencedaily.com/releases/2009/03/090303123802.htm
8) Exercise. HIIT and weight training is known to increase insulin sensitivity. My friend used to be a very active sportsperson in his school and college days but got out of action after starting work, due to an injury. Weight training is very good for strengthening injured bones and joints, because the stress can be varied slowly, and in a very controlled way. This should help him get back to sports.
Saturated fat and K2 will also help in fixing the bone and joint problems, as both help in structural formations.
http://www.unm.edu/~lkravitz/Article%20folder/diabetes.html
9) Fast. Occasional fasting can improve insulin resistance. It also increases the rate of tissue turn around, making a person younger (based on the life of average cells). It also increase growth hormone which also acts to make people feel younger. Higher tissue turnaround in arteries will enable faster repair of arteries. The following is just one of the first search results I got.
http://www.medindia.net/news/healthwatch/benefits-of-fasting-53257-1.htm
To recap.
1) Get a spoon of Cod liver oil every day. It will provide vitamin A, D and omega3s. You may want to get more Vitamin D3 if levels are not reached from Cod Liver oil. You may also need more omega3's from non-cod liver oil supplement if you don't get to a 1:2 O3:O6 ratio.
2) Avoid refined oils, they are the most concentrated source of omega6. Eat ghee or coconut oils as these have very low omega6 fats.
3) Reduce Carbs, wheat and sugar. Wheat should ideally be avoided completely.
4) Eat more greens and vegetables, for K1 and nitrates
5) Increase meat and healthy fat consumption, as it will help reduce carbs. Calories have to come from somewhere.
6) Eat aged cheeses, and ghee to improve K2 levels. There is benefit to supplementing it. Unfortunately due to low awareness the supplements are still too expensive.
7) Weight train to improve insulin sensitivity, and an overall sense of well being.
8) Fast occasionally. A 24 hour fast every week is ideal.
High Blood Pressure has a good short term solution, drinking beet root juice. It works by providing a high dose of nitrates. The nitrates convert to Nitric oxide and then to nitrous oxide. Nitrous Oxide dilates the arteries and results in decreased blood pressure. Nitrates are present in large quantities in leafy vegetables including spinach. Some vegetables will have more nitrates and others less. Beetroot is one of the highest in nitrates.
The real problem is the long term one. High Blood pressure generally indicates bad and constricted arteries, which leads to heart trouble.
My friends cholesterol is a bit higher, but that in my opinion is not a problem. In my opinion its not high enough ;-). It should be 200-240 according to this graph.
http://freetheanimal.com/images/2009/09/cholesterol-mortality.gif
His problem is triglycerides, which are very high, more than 200. As soon as these drop the cholesterol level will become normal.
Reducing triglycerides is very easy. They are directly related to carbohydrates. Reduce carbs and trigs will drop. Just for experiment you could eat a very low carb (< 50gm) high fat diet in the night and get your blood tested in the morning, you will find that the trigs have dropped, from your previous reading.
But that is not the real problem. The real problem is the calcification of arteries, which I am suspecting.
To find out how much of your arteries are calcified, you need to take a test called coronary calcium scoring.
It takes a special X ray to determine how much calcium exists in the arteries.
If indeed calcium score is high then you need to take several steps to get rid of it.
If you talk to a doctor they will say that it cannot be reduced. But it indeed can be reduced.
We have to understand first why calcification and coronary plaque happens.
There are several individual problems involved in heart disease.
1) The arteries get damaged. There may be several reasons for it. One is copper deficiency, another is microbial infection. Microbial (Chlamydophila_pneumoniae) infection will cause plaque buildup on its own.
http://wholehealthsource.blogspot.com/2010/04/copper-and-cardiovascular-disease.html
The microbial infection is possibly one of the major causes as the anti-bodies to this bacteria are higher in most people with heart disease.
2) If you have lots of small dense LDL, they have a tendency to get oxidized and get stuck into the damaged arteries. Then macrophages (white blood cells) get stuck to it trying to remove them. This causes plaque buildup.
http://en.wikipedia.org/wiki/Low-density_lipoprotein
3) Arterial Calcification is highly correlated with Diabetes, so much so that it is listed as the highest risk factor.
http://en.wikipedia.org/wiki/Atherosclerosis
Diabetes is the end stage of Insulin resistance. It is important to reduce insulin resistance to prevent arterial calcification.
4) Normally Calcification and Plaque buildup don't cause any problems if you don't get blood clots also called thrombosis. It is important to prevent clotting of blood.
http://en.wikipedia.org/wiki/Coronary_thrombosis
We have to attack each of the above to cure the heart disease.
1) Checking for Copper deficiency is difficult.
http://wholehealthsource.blogspot.com/2010/04/copper-in-food.html
You can see that potatoes are very good source for copper. But liver is the best. Some liver every week could be helpful.
2) To deal with bacterial infection it is important to increase your Vitamin D level to a good level from 40-80ng/ml. Use sun bathing. Use cod liver oil, or use vitamin D supplements but get this done. It is easy to get the Vitamin D test done in India. In Bangalore it costs 900/-. Be careful as some people with calcium regulation problems are not able to have a high vitamin D level. Hyperparathyroid or CKD may be suspected. Levels of upwards to 200ng/ml have been found in healthy individuals. 40ng/ml is the minimum acceptable level, but in lab ranges it may be the max level, because most city dwelling people are highly deficient. The ranges are based on people being tested which are all sick people from metros.
http://www.vitamindcouncil.org/
3) To reduce LDL Oxidation and to prevent calcification you need to reduce carbs in the diet. Reducing carbs reduces small dense LDL which prevents plaque formation.
http://cholesterol.about.com/od/lipoproteins/a/smalldenseldl.htm
Reducing carbs will also keep insulin low which should prevent further calcification.
We need to have energy. There is only so much protein a person can eat. If we reduce carbs, we need to increase fat.
4) The Calcification can be reduced by increasing intake of the Vitamin that is responsible for proper calcium utilization. The Vitamin K2.
http://wholehealthsource.blogspot.com/2008/11/can-vitamin-k2-reverse-arterial.html
It comes in two forms MK4 and MK7. The MK4 is the most effective vitamin but is very short lived. The MK7 is less effective but remains in the body for a much longer time. It can also get accumulated for later use. Vitamin K2 can also be utilized for other purpose where Vitamin K1 can also be used. Since it is difficult to get lots of K2. It is good to eat more vitamin K1.
Source of Vitamin K1 is Green Leafy vegetables.
Source of MK4 are milk, eggs and meat. Pastured Ghee is the most concentrated source of MK4.
Source of MK7 are fermented and aged cheeses like gouda, parmesan, etc.
5) Very important is to prevent clots in blood. It has been shown that higher Omega3:Omega6 ratio prevents clots in the blood. Inuits and other arctic dwellers who eat a lot of fish have a much higher omega3:omega6 ratio and had bleeding problems due to lack of clotting. They have a lot of coronary plaques and calcification but never get any heart problems because of this issue.
Our own diets are very high in Omega6. This causes the blood to clot sometimes. We need to balance the ratio to make sure that we don't have blood clots. There is a medicine called warfarin that is used to thin blood. But it works by blocking the action of vitamin K2. The K2 paper above used warfarin to induce calcification in rats.
The best option is to increase O3:O6 ratio in your body. You cannot test for it. It also takes a very long time in years to actually overturn the level, as the ratio is at the cellular level. But it must be attempted by reducing all high O6 sources in foods and increasing O3 sources. That is why I recommend to avoid refined oils which have higher than 10% O6. Try to calculate and add enough O3 to get nearer to 1:1. 1:2 would be OK but don't go below.
When increasing fat for reducing carbs this problem becomes much more acute. It is important to eat only fats that are very low in Omega6. The best oils are Ghee (<4%) and coconut oil(<2%), which are very low in Omega6. These have a lot of saturated fat, but contrary to popular belief saturated fats are very healthy. They are the most stable fats. Our body can desaturate them as it needs. They are the forms that our body creates from carbs. So fearing them is pointless. Even after eating lots of fats and meat for more than a year I have not been able to increase my dismal (<150) cholesterol.
Low O3:O6 ratio is also very closely related to heart disease.
http://wholehealthsource.blogspot.com/2009/05/eicosanoids-and-ischemic-heart-disease.html
http://wholehealthsource.blogspot.com/2009/05/eicosanoids-and-ischemic-heart-diseas.html
6) Avoid wheat. It is very much related to heart disease. It affects in two ways. First it is known to reduce Vitamin D3 levels in the body. Secondly it is also known to increase insulin resistance. Which forces the body to increase insulin levels.
http://rawfoodsos.com/2010/09/02/the-china-study-wheat-and-heart-disease-oh-my/
The data from China Study implicates Wheat. More than 60% relation between the two and with a better than 99.9% probability of the relation being true. This is a big deal.
7) Avoid Sugar. It is also very much related. The problem is mostly due to the fructose component of sugar. It affects insulin resistance directly.
http://www.sciencedaily.com/releases/2009/03/090303123802.htm
8) Exercise. HIIT and weight training is known to increase insulin sensitivity. My friend used to be a very active sportsperson in his school and college days but got out of action after starting work, due to an injury. Weight training is very good for strengthening injured bones and joints, because the stress can be varied slowly, and in a very controlled way. This should help him get back to sports.
Saturated fat and K2 will also help in fixing the bone and joint problems, as both help in structural formations.
http://www.unm.edu/~lkravitz/Article%20folder/diabetes.html
9) Fast. Occasional fasting can improve insulin resistance. It also increases the rate of tissue turn around, making a person younger (based on the life of average cells). It also increase growth hormone which also acts to make people feel younger. Higher tissue turnaround in arteries will enable faster repair of arteries. The following is just one of the first search results I got.
http://www.medindia.net/news/healthwatch/benefits-of-fasting-53257-1.htm
To recap.
1) Get a spoon of Cod liver oil every day. It will provide vitamin A, D and omega3s. You may want to get more Vitamin D3 if levels are not reached from Cod Liver oil. You may also need more omega3's from non-cod liver oil supplement if you don't get to a 1:2 O3:O6 ratio.
2) Avoid refined oils, they are the most concentrated source of omega6. Eat ghee or coconut oils as these have very low omega6 fats.
3) Reduce Carbs, wheat and sugar. Wheat should ideally be avoided completely.
4) Eat more greens and vegetables, for K1 and nitrates
5) Increase meat and healthy fat consumption, as it will help reduce carbs. Calories have to come from somewhere.
6) Eat aged cheeses, and ghee to improve K2 levels. There is benefit to supplementing it. Unfortunately due to low awareness the supplements are still too expensive.
7) Weight train to improve insulin sensitivity, and an overall sense of well being.
8) Fast occasionally. A 24 hour fast every week is ideal.
Saturday, December 4, 2010
Cancer: some more thoughts
I am trying to help a friend who might have cancer. It is a horrible disease. Hopefully even if it exists it will be in very early stages. It can be controlled when it is in early stages, with proper diet control and supplements.
As I wrote before, cancer feeds on glucose.
The trick to control is to keep the glucose in the system to bare minimum.
Also we want to keep the stress and inflammation to bare minimum. The above requirements mean a very accurate diet. Any diversion will feed the cancer.
First things first
1) Increase vitamin D3 to acceptable levels, ie 60ng/ml
Vitamin D3 and Cholesterol fight cancer cells. Supplement Vitamin D3 to atleast 5000IU, and get your serum level tested for 25OH Vitamin D levels. The best way is to get it partially from Cod Liver oil and partially from gelcaps. Testing is necessary because different people react differently to vitamin D. Some people raise their level very fast, but others don't do so. Some even might get some reaction to it, which would point to some other metabolic defect in the body like kidney problems or parathyroid problems.
Cholesterol will increase with more Coconut oil and ghee.
2) D3 increases blood serum calcium
We want to increase Vitamin K2 to help calcium to go where required, in bones. K2 is available from pastured butter and ghee, and aged cheeses. Luckily my friend likes blue cheese the richest source of vitamin K2, and can get kerrygold butter which is a very good pastured butter. Ghee can be made from the butter. Blue cheese is also very good for immunity as it replenishes gut bacteria. Gut bacteria are a very big factor in immunity.
3) Reduce Inflammation
Improve Omega3:Omega6 ratio. Get rid of all big sources of omega6, and get about 1gm of Omega3 from fish oil. You don't want to overdo omega3 as high PUFA in diet is not very good. Cod Liver oil is a good source, but you need to check the Vitamin D and Vitamin A levels in it. It will be best to get half of the omega3 from CLO and half of it from some other low Vitamin A oil like krill oil. Getting rid of all big sources of omega6 means avoiding all oils that contain higher omega6 content, basically limit yourself to ghee.
Limit carbs.
Humans all have very similar brain and neuron mass. Since brain and neurons are the only cells that need glucose, so we want to limit the glucose consumption to exactly what the brain and neurons require. Glucose requirement is around 100gm. It can be reduced by getting the brain to use more ketones. The method of providing ketones is to use coconut oil and fast. Coconut oil is very very rich in medium chain fatty acids. There is nothing as rich as Coconut oil. The MCFA get converted to ketones.
To reduce carb requirement, it is good to add one tablespoon of coconut oil to both meals of the day.
Use fasting to increase your ketone generation. The best way is to skip breakfast and do a 16 hour fast everyday.
With adequate combination of coconut oil and fasting the carb requirement can be reduced to below 50gms/day.
When counting carbs do not count fibers, because they do not convert into glucose. They are not processed by the liver or intestines enzymes, but by the gut bacteria. Gut bacteria convert them to short chain fatty acids. The SCFA's are anti-inflammatory. So it is good to add some fibers in the diet. Avoid insoluble fibers, as they damage the intestine. Good sources of soluble fibers are vegetables.
The best way to test whether you have enough ketones is to check urine with ketostix. If you have more than required ketones, then the excess will be discarded in the urine and will be detected by ketostix. Later when the body adapts to ketogenic diet, it will start storing the ketones as fat, then it will be difficult to measure ketones.
Divide your carb requirement into the two meals nearly equally to reduce too much glucose availability in the blood. It would not be a problem if sufficiently insulin sensitive.
Moderate proteins.
Proteins in excess convert to glucose. We do not want excess protein in the body. Still we need enough to prevent catabolization of muscles. We need enough for body's need. Calculate protein needs by finding out your lean body mass. The lean body mass is calculated by first finding out the body fat percentage, and then substracting the body fat weight from the body weight. A good way is to use those weighing machines with metal strip that calculate body fat percentage using the impedence method. Impedence method can be fairly accurate. Another way to calculate is to find your minimum weight at your maximum height. If you were very thin then assume 15% for men and 20% for women. If not thin enough then it will be difficult to estimate this way.
LBM is calculated in the following way.
LBM = WT(1-BF/100)
Once you have your LBM then calculate your protein requirement as 1.4gm/kg/day. The protein is best if it comes from animal sources. Fish/Meat/Eggs/Cheese are the best sources.
Fish will also provide vitamin D and Omega3s. So they will reduce the need for supplementation.
Whey powder should be added to the daily diet as it helps in producing more ketones. (Thanks Paul)
Fat requirements
To calculate fat requirements. Find your calorie requirements. Use this
calculator. Body fat % calculated above will be useful here.
Calculate your calorie consumption from Protein and Carbs calculated above using 4kcal/gm. Then add enough fat at 9kcal/gm to achieve the calorie requirement. You must also include the around 30-40gms of coconut oil that you are required to have in this requirement.
If you think you have excess fat on your body then reduce your calorie requirement by max 500kcal or 20% of your calorie requirement, whichever is lower. The reason is that with this diet the body will start using your own body fat also, reducing your caloric needs. Depending on the excess weight you can lose the weight at a rapid rate.
Other supplement requirements.
Very low carb increases requirement for electrolytes. The best electrolyte for the body is potassium. Make sure that you are getting more potassium than sodium intake from salts. Higher potassium requirement makes it necessary that you get all carbs from vegetables, because they are rich in potassium. Higher potassium from foods will reduce the need for supplementation. Avoid grains/legumes/milk as they will reduce your daily quota of carbs. Yogurt might be OK if sufficiently fermented. Fruits with higher carb content should be kept low.
Actually Potassium requirements are 4 times that of sodium. Try to mix potassium chloride in your salt. If you are falling short then supplement with potassium chloride or potassium gluconate. (Note: Need to determine daily potassium and sodium requirement, I know only the ratio).
Magnesium is also a very important requirement. Supplement about 400mg per day in two parts with meals.
Drink a lot of water 4-5 litres, as you want to get rid of the oxalates generated due to protein to glucose conversion.
Take 100-200gms of kidneys per week to provide selenium. Also add some more selenium as supplement.
Get Lugol's solution. Add it to your daily routine. Increase slowly doubling weekly, starting from 150mcg, reaching 12.5mg. If any problems are seen stop. It sometimes causes problems to people. My brother found that he had Hashimoto's due to the reaction he got from iodine supplementation.
Exercising.
You want to do some weight lifting or body weight exercises to prevent muscle catabolism. Consult the exercising article I wrote. This will also help in reducing any excess glycogen stores.
Extended fasting.
For dealing with cancer extended fasting is very important. Extended fasting gets the body into a state where it will try to utilize its proteins for fuel. In this case it attempts to use malfunctioning proteins over the well functioning ones.
Extended fasting has been known to help the body prepare for chemo therapy. It is also known to help kill cancers.
16hours daily fasting will prepare your body for extended fasting in addition to providing you with ketones. When you are comfortable with 16hour fasting then introduce extended fasting into your routine. It will be best to add one extended fast every week. Start with a 24 hour fast every week. Then introduce a 48 hour fast alternate weeks. Once you are comfortable with the 48 hour fast extend one of them every month to 72 hour or 3 day. Once you are comfortable with 3 day fast add one 7 day fast in 6 months. If you have to go in for chemo, plan it before the chemo.
In these fasts you are not trying to get any calories. But add salt preferably with potassium chloride, and lemon juice for vitamin C and some more nutrients. You wouldn't need any Omega3 or Vitamin D supplements. Make sure to get enough food and supplements to compensate when the fast is over.
Continue doing your exercises during the fasting. That will reduce the harmful effects of the fast.
Bottomline
Ultimately you are the best judge of everything. You live in your body and know best how your body is reacting to the diet plan. No doctor can understand your body better than you. If an advice does not feel good to your body it will not be good.
Caveat is that sometimes you do need about 2-3 weeks for a dietary change to become acceptable to the body. This change has everything to do with gut bacteria adaptation. So wait for 2-3 weeks before passing judgement on a dietary change.
You cannot rely on anybody to provide you with all the answers. This job rests on doctors, but unfortunately the doctors are too busy to care about their patients. You might have better luck with naturopaths and other alternative medicine practitioners, that use a holistic approach and are aware of the recent advances in biochemistry. These doctors/holistic practitioners are rare, and may require several attempts or luck to find one. It is well worth the effort to find one.
As I wrote before, cancer feeds on glucose.
The trick to control is to keep the glucose in the system to bare minimum.
Also we want to keep the stress and inflammation to bare minimum. The above requirements mean a very accurate diet. Any diversion will feed the cancer.
First things first
1) Increase vitamin D3 to acceptable levels, ie 60ng/ml
Vitamin D3 and Cholesterol fight cancer cells. Supplement Vitamin D3 to atleast 5000IU, and get your serum level tested for 25OH Vitamin D levels. The best way is to get it partially from Cod Liver oil and partially from gelcaps. Testing is necessary because different people react differently to vitamin D. Some people raise their level very fast, but others don't do so. Some even might get some reaction to it, which would point to some other metabolic defect in the body like kidney problems or parathyroid problems.
Cholesterol will increase with more Coconut oil and ghee.
2) D3 increases blood serum calcium
We want to increase Vitamin K2 to help calcium to go where required, in bones. K2 is available from pastured butter and ghee, and aged cheeses. Luckily my friend likes blue cheese the richest source of vitamin K2, and can get kerrygold butter which is a very good pastured butter. Ghee can be made from the butter. Blue cheese is also very good for immunity as it replenishes gut bacteria. Gut bacteria are a very big factor in immunity.
3) Reduce Inflammation
Improve Omega3:Omega6 ratio. Get rid of all big sources of omega6, and get about 1gm of Omega3 from fish oil. You don't want to overdo omega3 as high PUFA in diet is not very good. Cod Liver oil is a good source, but you need to check the Vitamin D and Vitamin A levels in it. It will be best to get half of the omega3 from CLO and half of it from some other low Vitamin A oil like krill oil. Getting rid of all big sources of omega6 means avoiding all oils that contain higher omega6 content, basically limit yourself to ghee.
Limit carbs.
Humans all have very similar brain and neuron mass. Since brain and neurons are the only cells that need glucose, so we want to limit the glucose consumption to exactly what the brain and neurons require. Glucose requirement is around 100gm. It can be reduced by getting the brain to use more ketones. The method of providing ketones is to use coconut oil and fast. Coconut oil is very very rich in medium chain fatty acids. There is nothing as rich as Coconut oil. The MCFA get converted to ketones.
To reduce carb requirement, it is good to add one tablespoon of coconut oil to both meals of the day.
Use fasting to increase your ketone generation. The best way is to skip breakfast and do a 16 hour fast everyday.
With adequate combination of coconut oil and fasting the carb requirement can be reduced to below 50gms/day.
When counting carbs do not count fibers, because they do not convert into glucose. They are not processed by the liver or intestines enzymes, but by the gut bacteria. Gut bacteria convert them to short chain fatty acids. The SCFA's are anti-inflammatory. So it is good to add some fibers in the diet. Avoid insoluble fibers, as they damage the intestine. Good sources of soluble fibers are vegetables.
The best way to test whether you have enough ketones is to check urine with ketostix. If you have more than required ketones, then the excess will be discarded in the urine and will be detected by ketostix. Later when the body adapts to ketogenic diet, it will start storing the ketones as fat, then it will be difficult to measure ketones.
Divide your carb requirement into the two meals nearly equally to reduce too much glucose availability in the blood. It would not be a problem if sufficiently insulin sensitive.
Moderate proteins.
Proteins in excess convert to glucose. We do not want excess protein in the body. Still we need enough to prevent catabolization of muscles. We need enough for body's need. Calculate protein needs by finding out your lean body mass. The lean body mass is calculated by first finding out the body fat percentage, and then substracting the body fat weight from the body weight. A good way is to use those weighing machines with metal strip that calculate body fat percentage using the impedence method. Impedence method can be fairly accurate. Another way to calculate is to find your minimum weight at your maximum height. If you were very thin then assume 15% for men and 20% for women. If not thin enough then it will be difficult to estimate this way.
LBM is calculated in the following way.
LBM = WT(1-BF/100)
Once you have your LBM then calculate your protein requirement as 1.4gm/kg/day. The protein is best if it comes from animal sources. Fish/Meat/Eggs/Cheese are the best sources.
Fish will also provide vitamin D and Omega3s. So they will reduce the need for supplementation.
Whey powder should be added to the daily diet as it helps in producing more ketones. (Thanks Paul)
Fat requirements
To calculate fat requirements. Find your calorie requirements. Use this
calculator. Body fat % calculated above will be useful here.
Calculate your calorie consumption from Protein and Carbs calculated above using 4kcal/gm. Then add enough fat at 9kcal/gm to achieve the calorie requirement. You must also include the around 30-40gms of coconut oil that you are required to have in this requirement.
If you think you have excess fat on your body then reduce your calorie requirement by max 500kcal or 20% of your calorie requirement, whichever is lower. The reason is that with this diet the body will start using your own body fat also, reducing your caloric needs. Depending on the excess weight you can lose the weight at a rapid rate.
Other supplement requirements.
Very low carb increases requirement for electrolytes. The best electrolyte for the body is potassium. Make sure that you are getting more potassium than sodium intake from salts. Higher potassium requirement makes it necessary that you get all carbs from vegetables, because they are rich in potassium. Higher potassium from foods will reduce the need for supplementation. Avoid grains/legumes/milk as they will reduce your daily quota of carbs. Yogurt might be OK if sufficiently fermented. Fruits with higher carb content should be kept low.
Actually Potassium requirements are 4 times that of sodium. Try to mix potassium chloride in your salt. If you are falling short then supplement with potassium chloride or potassium gluconate. (Note: Need to determine daily potassium and sodium requirement, I know only the ratio).
Magnesium is also a very important requirement. Supplement about 400mg per day in two parts with meals.
Drink a lot of water 4-5 litres, as you want to get rid of the oxalates generated due to protein to glucose conversion.
Take 100-200gms of kidneys per week to provide selenium. Also add some more selenium as supplement.
Get Lugol's solution. Add it to your daily routine. Increase slowly doubling weekly, starting from 150mcg, reaching 12.5mg. If any problems are seen stop. It sometimes causes problems to people. My brother found that he had Hashimoto's due to the reaction he got from iodine supplementation.
Exercising.
You want to do some weight lifting or body weight exercises to prevent muscle catabolism. Consult the exercising article I wrote. This will also help in reducing any excess glycogen stores.
Extended fasting.
For dealing with cancer extended fasting is very important. Extended fasting gets the body into a state where it will try to utilize its proteins for fuel. In this case it attempts to use malfunctioning proteins over the well functioning ones.
Extended fasting has been known to help the body prepare for chemo therapy. It is also known to help kill cancers.
16hours daily fasting will prepare your body for extended fasting in addition to providing you with ketones. When you are comfortable with 16hour fasting then introduce extended fasting into your routine. It will be best to add one extended fast every week. Start with a 24 hour fast every week. Then introduce a 48 hour fast alternate weeks. Once you are comfortable with the 48 hour fast extend one of them every month to 72 hour or 3 day. Once you are comfortable with 3 day fast add one 7 day fast in 6 months. If you have to go in for chemo, plan it before the chemo.
In these fasts you are not trying to get any calories. But add salt preferably with potassium chloride, and lemon juice for vitamin C and some more nutrients. You wouldn't need any Omega3 or Vitamin D supplements. Make sure to get enough food and supplements to compensate when the fast is over.
Continue doing your exercises during the fasting. That will reduce the harmful effects of the fast.
Bottomline
Ultimately you are the best judge of everything. You live in your body and know best how your body is reacting to the diet plan. No doctor can understand your body better than you. If an advice does not feel good to your body it will not be good.
Caveat is that sometimes you do need about 2-3 weeks for a dietary change to become acceptable to the body. This change has everything to do with gut bacteria adaptation. So wait for 2-3 weeks before passing judgement on a dietary change.
You cannot rely on anybody to provide you with all the answers. This job rests on doctors, but unfortunately the doctors are too busy to care about their patients. You might have better luck with naturopaths and other alternative medicine practitioners, that use a holistic approach and are aware of the recent advances in biochemistry. These doctors/holistic practitioners are rare, and may require several attempts or luck to find one. It is well worth the effort to find one.
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