Thin People Can Get Diabetes

The Thin Man's Diabetes
by Jeff O'Connell

Men's Health
April 16, 2008

The Deadly Truth About Diabetes

America's fastest-growing disease has a sugar-coated secret: You don't need to be overweight for it to kill you

By Jeff O'Connell

http://www.menshealth.com/print/21762

One of my most enduring childhood images is from a newspaper clipping. The grainy photograph freezes a lanky teen named Tom O'Connell launching a hook shot from his right thigh. Tucker, as he was known, led a team from tiny Merchantville High School in scoring and rebounding during an improbable run to the South Jersey Championship. New Jersey had its own version of Hoosiers in 1952, and for that one season, my father was his team's Jimmy Chitwood.

In February 2008, I arrive at a nursing home in the San Fernando Valley to visit the man in that photograph, a man I've neither seen nor spoken to in 20 years. Entering his room, I barely recognize the gaunt face. Where his right thigh should be sits a corduroy pant leg, gathered up and bobby-pinned. The spindly arm he extends to greet me is splotched with blood bursts. Once 6'3'' and 215 pounds, he's now a cadaverous-looking 145. The only cheerful note in the room is a balloon tied to the metal bed frame. His 73rd birthday was last week, apparently. It's a detail I had long since forgotten.

Like a man looking into a foggy mirror, my father strains to recognize me. But if he is staring into his past, I might be peering into my future. I'm 6'6'' and weigh 220, with 12 percent body fat and the outline of abs above a 32-inch waist. Yet diabetes has me in its crosshairs as well.

If you think being thin gives you a free pass from this deadly disease, well, it may have a surprise in store for you, too.

Come, sweet death

The white curtain flanking my father's bed divides him from a man who speaks only Spanish and another who rambles incoherently all day in English. Yet Thomas Joseph O'Connell Jr. has an epidemic's worth of company. According to the Centers for Disease Control and Prevention, one in every four people in the United States is living with either type-2 diabetes (20 million) or its precursor, prediabetes (54 million). And the incidence of type 2 -- the kind of diabetes that people develop over time -- has, in the past quarter-century, grown 32 percent faster among American men than among American women.

What's worse, type-2 diabetes is showing up in the young in record numbers. "People used to suffer type-2 diabetes in their 60s and heart disease in their 70s," says James O. Hill, Ph.D., the director of the center for human nutrition at the University of Colorado's health sciences center. "But with teens now developing it, are they going to have heart disease at 25 and need a transplant in their 30s? We've never gone through this before, but based on what we know about what happens once you have type-2 diabetes, the answer is probably yes."

Woe unto them, because raging blood sugar can lead to a litany of ailments biblical in scope: cardiovascular disease, liver disease, kidney failure (my dad needs dialysis three times a week), stroke, amputations, erectile dysfunction, blindness, and nerve damage -- everything, seemingly, but a swarm of locusts. Even cancer has a sweet tooth, recent research suggests.

The total amount of glucose in a typical man's bloodstream is just shy of the amount in a teaspoon of sugar. A man crossing over into diabetes has about ¼ teaspoon more. That seemingly trivial amount can make a huge difference as blood glucose (a.k.a. sugar) plays seesaw with your hormones all day. The game begins whenever you eat carbohydrates -- be it the sugar in a soda or the starch in bread and pasta. Your body breaks down these carbs so they can be absorbed into your bloodstream as glucose. The seesaw goes up: elevated blood sugar.

Glucose is important stuff -- the cells in your muscles and brain use it for energy. But too much of it coursing through your blood vessels, for too long, is ultimately deadly. "It's kind of like dynamite," says Mary Vernon, M.D., president of the American Society of Bariatric Physicians. "The body realizes it's dangerous, not to be left lying around." That's why people with diabetes are frequent bathroom visitors.

To adjust to a surge of incoming carbs, your pancreas secretes the hormone insulin, which helps glucose enter your cells, where it belongs. This glucose leaving your bloodstream is the downstroke of the seesaw. Problems arise when some of your cells begin to deny access to insulin, and by extension, glucose -- a condition called insulin resistance. This situation often goes unnoticed for years, but over time it worsens until the result is chronically high blood sugar and full-blown diabetes.

Here's how it all plays out: Your body tries to clear your bloodstream of excess glucose by signaling your pancreas to squirt out higher and higher amounts of insulin. Eventually, this flood of insulin drives blood sugar sharply lower, which makes you feel hungry and even shaky. So you reach for the quick fix -- more carbs -- and they send your blood sugar skyrocketing again, triggering the release of still more insulin and perpetuating the cycle. Instead of gently rocking, the seesaw slams down and bounces back up, over and over, for days, years, and decades. "The constant demand on your pancreas ultimately causes it to burn out, so that it no longer releases insulin," says Dr. Vernon. "That's when blood sugar stays elevated for good."

Of course, this insulin system has worked fine for 99.6 percent of human existence. That's because hunter-gatherers derived no more than 40 percent of their calories from carbohydrates, mostly fruit, according to Colorado State University scientists. What your pancreas wasn't designed to handle on a regular basis was the carb load from a Cinnabon washed down with a Big Gulp, all part of the 140 pounds of sugar the average American consumes annually. "The high- blood-glucose response to a high-carb diet is an almost normal response to an abnormal situation," says Ron Raab, past vice president of the International Diabetes Federation. "We've largely created this illness."

An ominous prefix

No single event fractured my relationship with my father. Lacking even the sense of purpose or legitimacy that a blowout argument or fight might have provided, the dissolution of our bond came after my parents divorced in the mid-1980s. Tom O'Connell had essentially been cast out of my mind for two decades until one of my two brothers told me that he was lying in intensive care in a Los Angeles hospital. He had diabetes and had barely survived two amputations on a leg, above the knee and then farther up. At the time, it didn't cross my mind to make the trip from eastern Pennsylvania to Southern California to say farewell.

I wouldn't be let off that easily, though. A week later I visited my own doctor, who had called me in to review blood work done several weeks earlier for a routine physical. He scanned my numbers and looked up. "Does diabetes run in your family?"

Bad medical news didn't shock me. Both of my parents survived cancer, and my mother has epilepsy. But I write for Men's Health. I've cowritten a book on sports nutrition. I've been the occasional butt of skinny-guy wisecracks in school. Diabetes? Isn't that for grandmothers in wheelchairs?

The doctor slid the lab report in front of me and began explaining the jumble of numbers. One stood out: 116, which quantified the amount of glucose floating in my bloodstream after a 12-hour fast. Under 100 milligrams per deciliter (mg/dl) is good; anything above 126 is diabetes. That meant I was well into prediabetes, a term sugarcoated in more ways than one, since most men eventually lose the prefix.

How the hell did I miss this? I thought. For months, my body had felt like a sputtering car in need of a tuneup. There were the severe headaches I had endured my entire adult life and the naps that left me so groggy it was like emerging from anesthesia. Then I replayed a scene from earlier that year. After months of nearly continuous stress, I woke up one morning feeling like a man who had been lost in a desert for days. I drank a glass of water, and another, and another, all weekend. Gallons, it seemed. Nothing could quench my thirst, a classic symptom of high blood sugar, since you're expelling so much fluid through your urine.

Within minutes of learning the reason for that episode, I would confront another harsh reality: Many physicians really don't have a clue about preventing type-2 diabetes in someone thin like me. My doctor mumbled something about switching from white rice to brown rice and told me to come back in 6 months, even though insulin resistance is a complex metabolic disorder requiring sophisticated, continuous management. What's more, the typical advice offered makes you wonder if Americans are being given an antidote against or a prescription for the disease. For example, everyone from my doctor to the American Diabetes Association (ADA) tells people with impaired blood sugar, or prediabetes, to make carbohydrate-rich foods such as breads and grains the foundation of their diets. This despite a growing body of evidence that points to carb reduction as the best anti-diabetes strategy. After all, there's another term for people who are insulin resistant: glucose intolerant. Meaning they don't respond well to carbohydrates. The higher the dose of carbs, the more problems those carbs cause.

This year, after decades of resistance, the ADA finally acknowledged low-carb dieting as a legitimate response to diabetes. Which goes to show that if you wait for a health organization to issue a position paper before attacking the disease, you may end up reading that paper from a hospital bed.

This isn't the failing of a single physician or organization. It's the breakdown of the U.S. medical system when it comes to nutrition. "Our medical establishment is set up to treat disease," says Susan M. Kleiner, Ph.D., R.D., a nutritionist in Mercer Island, Washington. "First-year med students rank nutrition among their top priorities. Yet by graduation, nutrition doesn't even make the list, because it's largely ignored." In fact, there are still medical schools that don't offer a single nutrition course.

Slash and burn

Perhaps I was scared by news of my father's fate or angry that the disease had cut him down. Maybe I was emboldened by the knowledge that type-2 diabetes comes with instructions for defeating it, even if most doctors don't know them. Whatever the motivation, I was determined to haul off and floor this condition with one ferocious counterpunch. At least initially, I adopted a very-low-carbohydrate approach -- specifically the Atkins diet -- based on multiple Duke University studies that show it's effective for both lowering blood sugar and reducing heart-disease risk. It seemed logical: The initial limit of 20 grams of carbohydrates a day would offer my pancreas a reprieve after a lifetime of sugar trauma.

Of course, I didn't know what 20 grams of carbohydrates would mean until I found myself in a supermarket pushing a shopping cart containing nothing but a can of shaving cream, laundry detergent, and a magazine. Everything in sight contained too much sugar for someone on the verge of diabetes, and some of the bachelor-friendly foods I'd relied on most were among the highest in carbs: frozen dinners and pizzas, cereal, cookies and other desserts, and snack foods. Bread, pasta, rice, and potatoes were gone from my list, too.

What remained was what some hunter-gatherers might have recognized as food had they been foraging on the periphery of a supermarket: fresh fruits and vegetables, nuts, eggs, and meat. The biggest adjustment came when I realized all the things I couldn't drink anymore -- regular soda, beer, and fruit juices included. What's more, I'd even have to limit milk, since an 8-ounce glass contains 13 grams of sugar. A typical meal became steak, fish, or chicken accompanied by steamed vegetables and a glass of red wine, a low-carb godsend.

In addition to following my new diet strategy, I planned to torch any excess sugar by working out briefly but intensively 6 days a week: superset-based weight-lifting sessions one day, cardio intervals the next.

Just how powerful an antidote is exercise? A study published recently in the American Journal of Physiology -- Endocrinology and Metabolism revealed that insulin resistance in rats decreased more from exercise than from taking metformin, the leading diabetes drug.

Exercise and dieting take effort and discipline, though. And it can be tempting to just take drugs to lower blood sugar and be done with it. After all, the major diabetes organizations have already raised the white flag of surrender and adopted that approach. "Two years ago, the ADA and the European Association for the Study of Diabetes decided that you really ought to just start people on medicine," says endocrinologist Larry C. Deeb, M.D., a past president for medicine and science at the ADA. "Very few people participate in dietary changes and physical activity, so you end up with patients not taking care of their diabetes. My take is, let me give you a prescription. No rule says I can't take you off the medicine later."

Yeah, except diabetes drugs are about as easy to ditch as crack -- most people end up using more, not less. It's a vicious circle: The insulin-resistant patient is shepherded onto a high-carbohydrate diet per ADA guidelines, so his blood sugar stays elevated. As a result, his pancreas secretes more insulin -- but with less and less effect. So he's given tablets to make his pancreas produce even more insulin. When that's not enough, he must inject the insulin. In contrast, when you exercise daily with few carbohydrates available for fuel, your body needs less insulin.

By my next doctor's appointment, my fasting blood sugar has fallen from 116 to 102 and my triglycerides from a high 289 to a better-than-average 89. (In the insulin resistant, these blood fats tend to rise with blood sugar.) Most impressive is my score on the hemoglobin A1C test, a 3-month running average of blood-sugar levels. The nondiabetic range is 4 percent to 6 percent. After months of exercising and carb slashing, my results fall squarely in the middle: 5 percent. In a word, perfect.

As I turn to leave, the doctor smiles and pats me on the back. "You're proof that diabetes can be addressed with diet and exercise," he says. "Most people don't do that. You're to be commended."

From high to low

"Actually, this is really bad."

The voice on the other end of the line belongs to Keith W. Berkowitz, M.D. He's the medical director of the Center for Balanced Health in New York City, which specializes in treating patients with serious blood-sugar irregularities. I had faxed the results to his office for a second opinion.

Dr. Berkowitz noticed a mathematical anomaly. While my A1C test was normal, my fasting-glucose score -- taken when my blood sugar should have been at its lowest -- was still too high. "For those two numbers to exist side by side means your blood sugar has to be in the 60s much of the time," he says. "Your biggest problem is hypoglycemia -- low blood sugar." (Hypoglycemia is defined as less than 70 mg/dl; normal blood sugar, between 70 and 100 mg/dl.) If Dr. Berkowitz was correct, my blood sugar was on a roller-coaster ride, with the perfect A1C averaging two extremes.

Dr. Berkowitz asked me to visit his office in midtown Manhattan, where I would take a stress test for my metabolic system. If fasting glucose is one still image and an A1C is a composite image, the oral glucose-tolerance test (OGTT) is like watching a movie, and it's more revealing as a result. In a study published in the journal Angiology, all three tests were given to 144 patients -- none of whom had been previously diagnosed with type-2 diabetes or impaired blood sugar. Yet 94 patients yielded OGTT results that revealed one of those conditions. The fasting-glucose test had missed 62 percent of those cases, and the A1C had missed 83 percent. "The last thing to go up is your fasting glucose," says Dr. Vernon. "The horse is already out of the barn at that point." That means the first signpost doctors are looking for is the last of the indicators to present itself.

My test begins with a lovely brunette in a white lab coat handing me a glass of a syrupy orange drink. It contains roughly the amount of sugar you would ingest from drinking two 12-ounce cans of Coke. Three hours into the test, even the pretty technician's gentle arm grab can't shake me from my stupor. But 20 minutes later, I suddenly become anxious, jittery. At 4 hours I start to feel more like myself again. Mercifully, the test ends.

"Sorry to have put you through all that torture," says a smiling Dr. Berkowitz a week later as he opens a manila folder containing my results. He was right -- my condition is called reactive hypoglycemia, and it may be diabetes's most brilliant disguise of all. First my blood sugar shoots up to a prediabetic 165, a spike that by itself presents a significant risk factor for cardiovascular disease, according to a paper published in the American Heart Journal. Because my insulin does a poor job of ushering sugar into cells, my pancreas ends up producing 10 times more insulin than it should, according to Dr. Berkowitz. "That's like using an atomic bomb to take out a small village," he says, except it's my pancreas that will be destroyed over time. The nuke has driven my blood sugar into the 70s an hour later -- but my insulin is still blasting away. It drives me down to 59 an hour after that -- nap time. Five hours have passed and my blood sugar is still 20 points below where it started.

Granted, my hypoglycemia was induced by a stress test using 75 grams of glucose. But the standard recommendation for people with diabetes (using the American Academy of Family Physicians guidelines) means consuming up to 180 grams of carbohydrates over the course of a day. Split among three squares, as the organization's president, James King, M.D., suggests, that's just half an ounce less than an OGTT's worth of carbohydrates at each and every meal. (That's a huge load even with its absorption slowed by some fat and protein.) "We use the OGTT as a metabolic stress test, and yet the mainstream advice prescribes a diet that produces that amount of carbohydrates at every meal," says Raab. "It just highlights the misunderstanding of how carbohydrates impact diabetes."

No wonder guys are bonking at their desks all afternoon. Your brain produces no energy itself, yet it sucks up 25 percent of the glucose circulating throughout your body while you're up, and about 60 percent at rest. During hypoglycemia, gray matter is literally starving. (That explains my headaches.) You become shaky, anxious, dizzy, sweaty, tired, and unable to concentrate. Your body does whatever's necessary to protect your brain, and that includes breaking down muscle tissue so that it can be converted to glucose. Which begins to reveal why someone built like my father or me could be fast-tracking his way to type-2 diabetes. Because our insulin resistance results in frequent periods of low blood sugar, our bodies spend a good chunk of the day eating our own muscle.

As a result, we stay thin instead of gaining weight, as is often the case for people with insulin resistance and type-2 diabetes. In fact, insulin resistance is typically thought to cause weight gain, and vice versa. All of which makes the "thin man's diabetes" that much more perplexing. "The physiques of people at high risk of diabetes are becoming less stereotypical, making the disease harder to diagnose," says Dr. Berkowitz. His observations are supported by science: "If you look at distributions of large numbers of people, it's striking that not only do the overweight tend to be insulin resistant, but 10 percent to 15 percent of non-obese people are, as well," says Donald W. Bowden, Ph.D., director of the center for diabetes research at Wake Forest University school of medicine. Clearly, no one should assume he's immune to this disease.

Sugar shocked

I'm not the only one whose A1C score has led to serious head scratching of late. In February, the National Heart, Lung, and Blood Institute halted part of a large study because too many diabetic patients at high risk for heart attacks and strokes were actually dying of them while they were being treated aggressively -- in some cases with multiple drugs and insulin injections -- to lower their glucose. The goal was to bring them into line with normal, as measured by the A1C. Fifty years of conventional wisdom regarding diabetes says this group should have had the best outcome, not the worst.

It may be the wild ups and downs--replayed several times a day for years or decades--that takes the biggest toll on the body. Yet rather than seeing high and low blood sugar as two sides of the same insulin resistance, most of the diabetes organizations I contacted don't even think about the low side where type-2 diabetes is concerned.

The CDC does acknowledge that reactive hypoglycemia exists, but it has no data for hypoglycemia among men in the United States with diabetes, according to a spokesman. But he goes on to say this: "No data provide sufficient evidence that reactive hypoglycemic leads to diabetes."

"I think reactive hypoglycemia is a big problem," says Dr. Berkowitz. "No, I take that back. It's a huge problem." He tells me what's at stake for me in this battle. "If you don't do what we've been talking about, you will, over time, become diabetic. There's absolutely no question about it." After seeing my father minus his entire right leg, I have no reason to doubt the good doctor.

Dr. Berkowitz says that for a glucose-intolerant person, when to eat is nearly as important as what to eat. It only makes sense: If you want that seesaw to move gently through a small range of motion instead of swooping, you need to tap it more than three times a day, right? So in addition to sticking with my reduced-carb diet, I need to eat before I become hungry and finish my third small meal of the day before most men sit down to lunch. Sure, it's inconvenient at times, but then, not as inconvenient as losing your limbs.

Breaking the chain

My father was once a formidable man. He should have wiped out type-2 diabetes like one of the giants he knocked off in that basketball tournament. But how could he? Unless he lives long enough to read this article, he'll die not knowing the name of the metabolic disorder -- reactive hypoglycemia -- that made him diabetic. Coincidentally, my second and final visit with him coincides with his evening meal, wheeled into the room by two orderlies. I watch as they gently prick his finger to measure his blood sugar--and then leave behind a meal that includes mashed potatoes and fruit juice. I wonder if they've ever measured him an hour after such a carb-laden meal. Not that it matters now. The damage is done.

Near the end of my research, I'm stunned to learn that my grandfather, Thomas Joseph O'Connell Sr., another thin man, died from type-2 diabetes. One reason my father got blindsided was that his father had moved on, and one reason I didn't see diabetes coming was that my father and I had parted ways. Consider it one of the unexpected costs of fathers and sons disconnecting: missing what should be obvious signs of family illnesses. Ironically, this disease also reunited us in the end and provided us with our one final bond. As I leave, I realize this isn't just the first time I've seen my father in 20 years. This is probably our last goodbye as well.

The night before my last blood draw for the lab work for this story, I begin my fast at 7 o'clock but still trudge off to the gym at 10 for a cardio blast. I also decide to rise at 6 the next morning; I want to hit the treadmill again for a few minutes of sugar burning before the nurse plunges a needle into my arm. For a year and a half, I've been determined to push that number under 100, no matter what it takes.

The alarm on my cellphone beeps. I roll over, gaze at the ceiling, and change my mind about the gym. What matters are the measurements I've already taken myself. In a year and a half, this disease has made me stronger, fitter, more determined, and more optimistic than I ever was before. In trying to lay claim to my body, diabetes unwittingly gave me a new lease on life instead.

When the lab results come back the following week, along with dramatic improvements in cholesterol and blood pressure, my fasting glucose registers 99. Those two digits say that my blood sugar is normal again. But I know better. Like millions of American men, my body can no longer handle processed carbs in anywhere near the quantities included in the typical American diet.

Type-2 diabetes still lies waiting for me. It just needs me to drop my guard and eat junk food, put sugar in my coffee, skip meals, fall out of shape, and forget for even a brief stretch that this metabolic fire needs only its oxygen to roar again.

That's all the breathing room this deadly disease needs to take me down -- and maybe you, too.

Will you become diabetic? Take our self-test and find out

The American Diabetes Association singles out the fasting glucose test as the preferred way to diagnose type-2 diabetes, citing cost and ease. While useful, this blood-sugar snapshot doesn't reveal the excessive swings that indicate insulin resistance before your fasting level is elevated to diabetes or prediabetes.

For that, you need to take an oral glucose-tolerance test (OGTT), especially if you have a parent or sibling with type-2 diabetes. Being African American, Latino, Native American, or Asian American also elevates your risk. The symptoms of insulin resistance tend to come in clusters, so if you have one indicator, you're likely to have two or three others. How-ever, under the "definitely" category (below), having just a single factor is cause for concern. In this case, contact your physician and schedule a time for an OGTT.

You might need an OGTT if...

1 You often wake up with a headache

2 You often wake up in the middle of the night

3 You had acne, numerous cavities, and hair loss in your teens/early 20s

4 You feel cranky or forgetful after a high-carb breakfast

You probably need an OGTT if...

1 Your blood pressure is 140/90 mm/Hg or higher

2 Your HDL (good) cholesterol is less than 35 mg/dl (milligrams per deciliter) and/or your triglycerides are higher than 250 mg/dl

3 You're thirsty or you urinate a lot

4 You tire easily and/or nap frequently, especially 1 to 2 hours after a meal

5 You're overweight (BMI 25 to 29.9)

6 You're 45 years old or older

You definitely need an OGTT if...

1 Your fasting plasma glucose (FPG) is 100 mg/dl or higher

2 Your hemoglobin A1C is greater than 6 percent

3 Any random blood glucose reading is 140 mg/dl or higher

4 You have any history of cardiovascular disease

5 You're obese (BMI = 30 or higher)

http://www.menshealth.com/health/deadly-truth-about-diabetes

How Do I Know if I am Leptin Resistant?

Jack Kruse, MD lost about 140 pounds after he let go of conventional medical thinking and realized that the hormone leptin was the key to losing weight and changing his metabolism.

Listen to Dr. Kruse Discuss leptin on the Get Better Wellness podcast HERE.
Read articles by Dr. Kruse on his website.

"My own personal story of change led this transformation in thinking for me about 5 years ago. My before and after pictures may surprise some but my thought evolution was far greater. That change has allowed me to focus on what really matters, and that is health, biochemistry, and evolutionary medicine to mold the future of healthcare.

It was what I used to guide my own personal change. Patients want results and they are now mandating that it happen on their terms. I love this change in thought. Patients who embrace this concept are now using technology to allow them to “quantify” themselves against metrics they know promote health based upon these evolutionary principles. They reject the dogma that has been healthcare for the last 200 years. They realize that they can no longer afford to abdicate the decision process to someone else. They no longer want to feel helpless. They want some degree of control back."

Listen to Dr. Kruse Discuss leptin on the Get Better Wellness podcast HERE.

Read articles by Dr. Kruse on his website.

How do I start? The Leptin Prescription.

Retrain the hypothalamus for Leptin Sensitivity

To: @digisurg Dr. Jack Kruse:
Is this what you have found ncbi.nlm.nih.gov/pubmed/22029981

Long-term persistence of hormonal adaptations to weight loss.

Sumithran P, Prendergast LA, Delbridge E, Purcell K, Shulkes A, Kriketos A, Proietto J.

Abstract
Background
After weight loss, changes in the circulating levels of several peripheral hormones involved in the homeostatic regulation of body weight occur.

Whether these changes are transient or persist over time may be important for an understanding of the reasons behind the high rate of weight regain after diet-induced weight loss.

Methods
We enrolled 50 overweight or obese patients without diabetes in a 10-week weight-loss program for which a very-low-energy diet was prescribed.
At baseline (before weight loss), at 10 weeks (after program completion), and at 62 weeks, we examined circulating levels of leptin, ghrelin, peptide YY, gastric inhibitory polypeptide, glucagon-like peptide 1, amylin, pancreatic polypeptide, cholecystokinin, and insulin and subjective ratings of appetite.

Results
Weight loss (mean [±SE], 13.5±0.5 kg) led to significant reductions in levels of leptin, peptide YY, cholecystokinin, insulin (P<0.001 for all comparisons), and amylin (P=0.002) and to increases in levels of ghrelin (P<0.001), gastric inhibitory polypeptide (P=0.004), and pancreatic polypeptide (P=0.008). There was also a significant increase in subjective appetite (P<0.001).
One year after the initial weight loss, there were still significant differences from baseline in the mean levels of leptin (P<0.001), peptide YY (P<0.001), cholecystokinin (P=0.04), insulin (P=0.01), ghrelin (P<0.001), gastric inhibitory polypeptide (P<0.001), and pancreatic polypeptide (P=0.002), as well as hunger (P<0.001).

Conclusions One year after initial weight reduction, levels of the circulating mediators of appetite that encourage weight regain after diet-induced weight loss do not revert to the levels recorded before weight loss. Long-term strategies to counteract this change may be needed to prevent obesity relapse.

Reply: by @Digisurg

Erin this study points out epigenetic hard wired switches in brain. They only modulated calories and saw no long term change.

Leptin will try to recapture lost weight as its main function.
You must retrain the hypothalamus using alternative circuits

once learned the hormones all will change.

This can take four to six yrs of continuing to us circadian exercises to allow the hypothalamic neural circuits to rewire. The exact same thing occurs in gastric bypass. The brain rewires the new neural maps of the gut to figure out how to account for sensory input.

This is why major weight loss happens year one and plateaus.

In reply to…

GetBetterDiet Erin Chamerlik @DigiSurg so do most people need 4-6 years of eating the Leptin RX to change? Here's all the pieces in one place ya'll: tinyurl.com/45xymwv

	DigiSurg Jack Kruse @GetBetterDiet most people no. But the massively overweight might. Oct 29, 3:13 PM

"We have found virtually no relationship between the percentage of calories from fat and any important health outcome."

"We have found virtually no relationship between the percentage of calories from fat and any important health outcome." Walter Willet, MD, DrPH, Chairman of the Department of Nutrition at the Harvard School of Public Health

The following information is found on Jonny Bowden's blog HERE

A new study adds to the growing body of research exonerating dietary fat from another of the many ills it's been blamed for.

Poor dietary fat. It gets scapegoated for so many things. Obesity, diabetes, heart disease, you name it, I guarantee you it’s been blamed on eating too much fat.

Trouble is, it’s just not true.

Don’t believe me?

Listen to Walt Willett.

Walter Willett, MD, DrPH, is Chairman of the Department of Nutrition at the Harvard School of Public Health, one of the most respected nutritional researchers in the world, and head of two of the most famous ongoing studies of diet and disease ever undertaken. Here’s what he said to Harvard University World Health News in an interview on March 29, 2000:

"The relationship of fat intake to health is one of the areas that we have examined in detail over the last 20 years in our two large cohort studies: the Nurses Health Study and the Health Professionals Follow-up Study.

We have found virtually no relationship between the percentage of calories from fat and any important health outcome."

OK, got that?

Dietary fat isn’t related to anything...

• not diabetes
• not cancer
• not even obesity

---

The type of fat? Yup!

Trans-fats, for example, which makes everything worse, and omega-3’s for example, which make everything better.

And the type of carbohydrate? Definitely. But the percentage of fat?

Nada. Zilch.

Now a new study adds to the research supporting what Willett has been saying for a decade.

In a study published in the American Journal of Clinical Nutrition, researchers investigated the relationship of dietary fat to breast cancer risk by using estimates of fat intake from both food diaries and food-frequency questionnaires, pooled from four different prospective studies in the United Kingdom.

They took a total of 657 cases of breast cancer in premenopausal and postmenopausal women and matched them with 1911 control subjects. They recorded nutrient intakes from food diaries and food frequency questionnaires and cross tracked the results with breast cancer. Specifically, they were looking for any association between the incidence of breast cancer and the intake of saturated, monounsaturated or polyunsaturated fat.

They found none.

As a matter of fact, a slightly protective effect was found when the amount of fat in the diet was higher. The participants in the highest (compared to the lowest) quintile of "percent calories from fat" actually had about a 10% reduction in the likelihood of breast cancer.

Now if this seems to contradict what you may have heard about fat and cancer, let me clarify.

Extra fat on your body- especially when you have a lot of it—is a risk factor for cancer. That’s because your fat cells are little endocrine organs, pumping out all kinds of hormones and inflammatory compounds some of which can increase the risk for cancer.

But fat on your hips ain’t fat on your plate, and they are not the same thing.

You don’t get fat from eating fat, you get fat for many reasons one of which is eating more food than your body needs. It doesn’t matter a whit what percentage of that extra food comes from fat; and if you’re lean-- and eating just the right amount of food to stay that way-- it also doesn’t matter what percentage of that food is fat.

In fact, since fat has virtually no effect on insulin, a bunch of of calories from fat will not stimulate your fat storing hormone the way an identical number of calories from cereal or sugar will.

Bottom line—do something about fat on your hips. But don’t worry so much about fat on your plate—as long as it’s not trans-fat, and as long as it came from whole food sources, and as long as it isn’t damaged by high heating or reheating, the fat on your plate is nothing to worry about.

Warmly,

Jonny Bowden
The Rogue Nutritionist

Holistic Psychiatrist Uses Elimination Diet

"One only sees what one looks for, one only looks for what one knows." - Goethe

Eggs!

by Judy Tsafrir, MD

I would like to share with my readers a personal experience that reinforced my respect for the power of food sensitivities, and may perhaps result in your own reflections linking specific foods with symptoms that trouble you. Before I discovered GAPS, I had been on a fruitless lengthy search for treatment of constipation that had plagued me since childhood.

I received no effective help from conventional medicine, nor from a variety of alternative health care practitioners. I had tried many approaches, but never an elimination diet. Last December I heard an interview with holistic nutritionist Erin Chamerlik on The Livin La Vida Low Carb Show. She described the success she had using an elimination diet with her clients to alleviate multiple distressing diverse symptoms. I decided that in accordance with my no stone left unturned nature, that I should venture down that avenue. I contacted Erin and began to work with her to identify what foods might be contributing to my symptoms.

For those of you who do not know what an elimination diet is, it typically consists of an avoidance of the top allergenic foods, i.e. gluten containing grains, dairy, soy, eggs, peanuts, corn, nightshades, shellfish, additives, sugar, alcohol, etc, for a few weeks. After that period, each class of food is carefully and systematically reintroduced one at a time. A food that has been avoided is reintroduced at both breakfast and lunch, and then for the next three days, one watches for a reaction, such as a rash, headache, joint pain or swelling, really any sort of unusual symptom.

Food sensitivities frequently may not manifest immediately. They are different than a dramatic anaphylactic reaction which occur in people who are, for example, allergic to peanuts or bee venom. In those cases a person may experience immediate life threatening tissue swelling, resulting in restriction of their airways. Symptoms related to food sensitivities may be far more subtle and delayed, so careful self observation is necessary. Despite their subtlety, symptoms related to food sensitivities can be extremely serious and debilitating.

I have maintained a low carb diet for years because of a family history of obesity, metabolic disorder and my own tendency to gain weight, when my diet is high in carbohydrates. Eggs have always been a happy staple of my diet. In the reintroduction phase of the elimination diet, I was astonished to discover that when I ate eggs, a feeling of profound agitation and dysphoria came over me which lasted all day, and I did not sleep the entire night. Insomnia is another symptom that I have had since childhood, but not like that. It was an extremely unpleasant and powerful reaction. I must have become sensitized to the eggs, because that reaction was nothing familiar to me from my habitual multiple times a week egg consumption. After that experience, I avoided eggs for the next 6 months. My constipation persisted as did my low grade insomnia, but my mood was restored.

Dr. Natasha is not a fan of elimination diets. She believes that they can be very confusing, especially for the person who seems to be reacting to everything. One day it seems like it is to this, the next to that, until the poor subject becomes hopelessly confused. Eventually she may feel unable to eat anything with a feeling of safety. For this reason, Dr. Campbell-McBride recommends the GAPS approach to heal and seal the gut lining, which according to her theory is at the heart of the matter. Gut dysbiosis results in damage to the gut lining, allowing food particles, microflora and toxins to diffuse out of the intestine affecting the body and brain, causing an inflammatory response with potential symptoms related to every organ system.

Once the gut is healed, many food sensitivities can disappear, and foods that previously caused a reaction, may be well tolerated. After having been on GAPS for three months, I decided, in accordance with this hopeful notion that I might now be able to eat eggs again, to try them. I started with a small amount, and it seemed like it was fine. I was delighted. Eggs are so great! They are versatile, nutritious and convenient. I just love them. I began to do some wonderful GAPS friendly baking, eggs for breakfast and in my soups and did not think more about it.

A couple of months later I started to feel really anxious and down. My sleep was disrupted and I had continuous hot flashes day and night. I was in a perpetual state of major autonomic dysregulation. Mornings I was exhausted from lack of rest and sweating all night. I could not figure out what was going on, as there was nothing in my life that was upsetting or different. Was this some resurgence of menopausal symptoms? Suddenly I thought of the eggs. Could it be that I was reacting to them again? I stopped eating them and within two days I felt happy again, the hot flashes were reduced by ninety percent, and my sleep improved.

So now, I am off eggs again. At the GAPS Practitioner’s Training I asked Dr. Campbell-McBride if a person followed GAPS for two years and had healed and sealed their gut, could a food allergy, such as an egg allergy persist? She said, “Absolutely” and went on to say that it might be due to a parasite or fluke that was lodged somewhere and was continuing to cause that sensitivity. I thought that was fascinating. I never considered that a food allergy could be related to a parasite.

I have not given up yet about the eggs. It may have been too early in my healing process to reintroduce them. I may be allergic to just the yolk or the white, and I have not sorted that out yet either. A skin sensitivity test may be helpful in that regard. I will let you know what happens. My father and brother were allergic to eggs. They had canker sores and peeling skin on their fingers when they ate eggs. My manifestations were all psychiatric and autonomic, anxiety, depression, insomnia and hot flashing. So, that is interesting, that the same allergy manifested completely differently. If I had gone to see a conventional psychiatrist with my symptoms, I would probably have been prescribed an anti-depressant, hypnotic, and hormone replacement therapy.

I do not agree with Dr. Natasha that elimination diets are fundamentally not useful. In certain situations, they can be a clarifying tool. In my own case, for example, it helped me figure out that I was reacting to eggs. Often when I try something on myself, I also invite my patients to try my experiment as well. Several joined me on the elimination diet with Erin, and discovered that their migratory arthritis was related to gluten, their severe stomach pains related to gluten and soy, quinoa caused a rash, that sluggishness and rash appeared when they ate gluten, and dairy caused migraines. This was all crucial information. These were not, however, people who felt safe eating only three foods. Their sensitivities were much more circumscribed. In cases where people feel safe eating only a handful of foods, it makes much more sense to start with the GAPS Introductory Diet.

GAPS also offers the possibility that one day, these food sensitivities maybe alleviated, instead of having to avoid the foods for the rest of your life. Omitting the offending food is not really addressing the underlying problem. I do think, however, that elimination diets can have a place in sorting things out, and Erin Chamerlik was very helpful and responsive. She works on-line, so geography is not an issue. I recommend her if you decide to go that route. Also, as I have mentioned in other posts, many people are not ready to make the commitment necessary for GAPS, so if initially they can figure out which food is causing a serious problem, that is already a big improvement.

The elimination diet did not help my constipation or insomnia, GAPS is helping me with that. I am hoping that one day I will be able to enjoy eggs again. It may be a dosage question. Maybe a bit could be tolerated once in awhile until further healing occurs, or maybe that’s just the way it is always going to be.

Transit Time and Digestion

Transit Time

We should be having a bowel movement at least once or twice a day
Some may not for days and some children have been known to hold it for weeks.

Bowel transit time refers to
• the length of time it takes for food to move through the digestive system
o Starting with the time a food is eaten and ending when that food is evacuated from the body with a bowel movement.
o Depends on the types and amounts of food consumed and the digestive health of the individual.
o Optimal range is 16 - 40 hours.

Too fast – not absorbing nutrients
Too slow
– Encourages harmful bacteria to grow and proliferate.
– Putrification is when food is not well digested so it sits inside us and rots.
o Causes bloating, discomfort and indigestion.
o If we eat too much fat and meat and not enough vegetables with fiber this could lead to a slow transit time.
o Eat more fruits, vegetables and oils. Drink more water. Avoid alcohol, soda, coffee which dehydrate. Exercise. Add magnesium glycinate.

How to Test Transit Time

1. Select a marker. A marker is an edible substance that when ingested, will move through the digestive tract and be visible in the stool upon evacuation.
a. 2-3 beets
b. 10 Charcoal capsules
c. 2 Tbs of liquid chlorophyll
d. If stools are typically dark, choose a light colored marker such as a tablespoon or two corn kernels or sesame seeds.
2. Ingest the marker after the first bowel movement of the day.
3. Record the time the marker was ingested.
4. Keep a diet, activity and stress record. These are factors that can significantly influence bowel transit time.
5. Observe the next bowel movements and record the time the marker is first noticed. If the marker appears again in a subsequent bowel movement, record that time as well.

Jimmy Moore was 410 Pounds

Do you know Jimmy Moore?

Formerly 410 pounds, Jimmy lost 180 pounds following the Atkins plan and kept it off for many years by eating a carbohydrate-restricted, high fat, moderate protein diet.

Recently Jimmy and his wife, Christine, have improved the way they eat by focusing on a paleo-type plan. Still low-carb, no/low grains, but loaded with organic pasture-raised meats, fish, chicken, eggs, vegetables, some fruit... REAL FOOD - whole food. Nothing from boxes, no artificial sweeteners, no beaver extracts.

See his mouth-watering low-carb paleo food pix HERE.

What can low-carb (low/no grains, lots of veggies, a little fruit) do for you?

Jimmy lost 180 pounds, was able to stop taking all medication, including drugs for high cholesterol, high blood pressure and breathing problems.

Recently I interviewed Jimmy Moore, of Livin La Vida Low Carb, author of two books, and host of several popular podcasts.

Listen to the interview HERE.

This interview was very popular the week it ran, jumping to #3 out of 1200 health podcasts on Blog Talk Radio.

WARNING! The following paragraph has been scrubbed so that my entire newsletter doesn't end up quarantined in the dark abyss of your spam folder. I use S__ for a word that rhymes with Rex. Duh.

Now Sean Croxton's interview with Kaayla Daniel, S__ and the Soybean, is blowing my interview out of the water. If you think soy is a health food, if you feed soy formula to your baby, if you eat Tofurky, please listen to the podcast.

Beaver Nasty Bits

Beaver Nasty Bits

by Erin Chamerlik

Remember Johnny Carson, The King of Late Night, host of the Tonight Show for 30 years until 1992 - ok, that eliminates most of you under the age of 35.

Johnny had a recurring role that he played on the show, Carnac the Magnificent. According to highly credible sources (since I'm far to young to have ever watched this show)

Carnac would hold an envelope to his head to "divine" the answer to a question sealed inside. He would announce the answer then open the envelope to reveal the answer.

Here's one from the Carnac files:

Johnny: The answer is "Gatorade"

Johnny rips open the envelope, pulls out a card and reads,

"What does an alligator get on welfare?"

Let's play that game today.

Answer: Beaver Nasty Bits

Question: What is often used to make raspberry or vanilla flavor in some beverages, candy, pudding and other foods?

Castoreum is derived from the hind end of a beaver. Specifically, the castor sacs. Whatever.

(BIG EWWWWW factor here. Who was the first person to taste these things and think, "Yummo! I detect a hint of raspberry, or no, is it the essence of vanilla?" Warning to the squeamish, do not Google Images "beaver castor")

If it tastes like vanilla or raspberry, but you don't see the ingredients "raspberry" or "vanilla" on the ingredients list, be afraid. Be very afraid.

Food manufacturers are allowed to call this beaver juice, "natural flavoring" or "natural raspberry flavor"

Next time you are eating something with raspberry or vanilla flavor, let this picture come to mind and check the ingredients.

Answer: Secretions from a colony of female lac insects.

Question: What is often used to make food shiny?

I know! I'm mad too! We pay good money for our highly processed food in America, we deserve better!

The candy called Hot Tamales that you (used to) enjoy is covered in "confectioner's glaze" (aka beetle juice).

Your shiny medications and vitamins are covered in "pharmaceutical glaze" - enteric coated pills often use this.

Those happy little colorful sprinkles for your ice cream treat - beetle juice.

Lac insects secrete gunk very similar to shellac. The food industry calls it some sort of glaze. You have been warned. Read labels!

Answer: Squashed red bugs.

Question: What is often used as a "natural" dye to color food red?

I just have one thing to say, heebie-jeebies!

Yes, if the food manufacturer does not use Red dye #40 (carcinogenic?) to make your food red, then they might use an ingredient called carmine.

Carmine is extracted from the insect's body and eggs and mixed with aluminum or calcium salts.

Viola! Red dye.

The label will say "carmine" and the front of the package will say "all natural".

Yoplait Strawberry Yogurt and Ruby Red Grapefruit Juice are two products with bug body and egg extractions.

There's more, but I have to move on. The best advice I can give is to stop eating processed food coming off the end of a factory line. Eat food found in a garden or at a farm, or the farmers market or the perimeter of the grocery store.

Like I always say,

One ingredient.

No worries.

No nasty bits.

What you CAN do to PREVENT Breast Cancer

What Can You Do to Actually PREVENT Breast Cancer

by Dr. Mercola - Entire Article HERE

While it is certainly helpful to identify cancers as soon as possible, even better would be to engage in lifestyle changes that would dramatically reduce or virtually eliminate your risk of developing breast cancer to begin with. This includes:

• Optimize your vitamin D levels. Vitamin D influences virtually every cell in your body and is one of nature's most potent cancer fighters. Vitamin D is actually able to enter cancer cells and trigger apoptosis (cell death). When JoEllen Welsh, a researcher with the State University of New York at Albany, injected a potent form of vitamin D into human breast cancer cells, half of them shriveled up and died within days. It was as effective as the toxic breast cancer drug Tamoxifen, without any of the detrimental side effects and at a tiny fraction of the cost.
  
  If you have cancer, your vitamin D level should be between 70 and 100 ng/ml. Vitamin D works synergistically with every cancer treatment I'm aware of, with no adverse effects.
• Normalize your insulin levels. A primary way to accomplish that is to avoid sugar, especially fructose, as well as grains (including organic ones). Aside from causing insulin resistance, all forms of sugar also promote cancer. Fructose, however, is clearly one of the most harmful and should be avoided as much as possible.
  
  Also make sure to exercise regularly, especially with Peak 8, as exercise is one of the best ways to optimize your insulin levels.
• Get plenty of natural vitamin A. There is evidence that vitamin A also plays a roll in helping prevent breast cancer. It's best to obtain it from vitamin A-rich foods, rather than a supplement. Your best sources are organic egg yolks, raw butter, raw whole milk, and beef or chicken liver.
  
  Beware of using oral supplements as there's some evidence that vitamin A can negate the benefits of vitamin D. Since appropriate vitamin D levels are crucial for your health in general, not to mention cancer prevention, this means that it's essential to have the proper ratio of vitamin D to vitamin A in your body.
  
  Ideally, you'll want to provide all the vitamin A and vitamin D substrate your body needs in such a way that your body can regulate both systems naturally. This is best done by eating colorful vegetables (for vitamin A) and by exposing your skin to safe amounts sunshine every day (for vitamin D).
• Avoid exposure to xenoestrogens, such as phthalates and BPA. These chemicals mimic natural estrogen, which is a breast cancer promoter.
• Avoid charring your meats. Charcoal or flame broiled meat is linked with increased breast cancer risk. acrylamide—a carcinogen created when starchy foods are baked, roasted or fried—has been found to increase breast cancer risk as well.
• Avoid unfermented soy products. Unfermented soy is high in plant estrogens, or phytoestrogens, also known as isoflavones. In some studies, soy appears to work in concert with human estrogen to increase breast cell proliferation, which increases the chances for mutations and cancerous cells.
• Maintain a healthy body weight. This will come naturally once you cut out sugar, fructose and grains, and start to exercise. It's important to lose excess body weight because fat produces estrogen.
• Drink a quart of organic green vegetable juice daily. Please review my juicing instructions for more detailed information
• Get plenty of high quality animal-based omega-3 fats, such as krill oil. Omega-3 deficiency is a common underlying factor for cancer.
• Take curcumin. This is the active ingredient in turmeric and in high concentrations can be very useful in the treatment of breast cancer. It shows immense therapeutic potential in preventing breast cancer metastasis. It's important to know that curcumin is generally not absorbed that well, so I've provided several absorption tips here.

** And I would add, eat only REAL food (not processed), and opt for thermography as a safe screening tool.**

Read the entire article by Dr. Mercola here

Here is the link to GreenMEDInfo.com
"These 33 studies provide evidence that x-ray mammography is a carcinogenic procedure that may harm between 10-50 more women than it helps.*

*For every woman whose life is prolonged through diagnosis 10 women are "unnecessarily treated," i.e. their life is shortened. Moreover, the type of "low energy" used in x-ray mammography when compared to the higher energy radiation associated with atomic bomb radiation, is up to 5 times more carcinogenic/DNA disruptive. This is why one can say that 50 women are harmed for every one woman helped."

Is Liquid Smoke Safe? Is Liquid Smoke Healthy? Is Liquid Smoke Carcinogenic?

Is Liquid Smoke Safe? Is Liquid Smoke Healthy? Is Liquid Smoke Carcinogenic?

Erin Chamerlik, MS, MT(ASCP)

I found a recipe I wanted to use but noticed that it contained bottled liquid smoke. It is hard to get that smokey flavor when we don't BBQ food. Is liquid smoke safe to use?

Many products contain MSG, but not all do. Let's assume you are using a product without MSG or other ingredients that may contain free glutamates and labeled as "natural flavor" or "artificial flavor".

How is liquid smoke made (when it is not made with chemicals)?

http://www.colgin.com/public/lsfaq.aspx#howmade

From the Colgin website we read, "Colgin Liquid Smoke is ... genuine wood smoke "liquefied." The wood is placed in large retorts (1) where intense heat is applied, causing the wood to smolder (not burn). (2)
Have you ever seen meat smoked in the old-fashioned way, in a smoke house? If so, you saw drops of dark brown liquid forming on the meat. That was smoke that had condensed into liquid form. Colgin Natural Liquid Smoke is produced by burning fresh cut hickory, mesquite, apple, and pecan wood chips at extremely high temperatures and moisture levels."

What Does the Science Tell Us?

Researchers from the Department of Food Science and Nutrition, Michigan State University, 1993 published a study, Polycyclic aromatic hydrocarbons in smoked food products and commercial liquid smoke flavourings.

• 18 commercial liquid smoke products and seasonings were analyzed for the presence of polycyclic aromatic hydrocarbons (PAHs), both carcinogenic and non-carcinogenic PAHs.

• The study concluded: "In liquid smoke flavorings and seasonings, total PAH concentrations ranged from 6.3 to 43.7 micrograms/kg, with the carcinogenic PAHs ranging from 0.3 to 10.2 micrograms/kg."

• Published in the journal, Food Additives & Contaminants. 1993 Sep-Oct;10(5):503-21.

Another study looked at PAH concentration from different wood sources used to obtain the liquid smoke. Read it here. J Agric Food Chem. 2000 Oct;48(10):5083-7.

Concentrations of PAHs in smoked foods has been found to be higher in home "wild" smoked products and smoked farm products. (Safety Analysis of Foods of Animal Origin)

This information is widely discussed in Europe:

The European Food Safety Authority (EFSA) says one of the flavorings used to give smoke flavour to meat, cheese or fish, may be toxic to humans.

BBC NEWS
The authority looked at 11 smoke flavourings commonly used in the European Union.
It says several of the flavourings are dangerously close to levels which may cause harm to humans.
The European Commission will now establish a list of smoke-flavouring products that are safe for use in food.
The smoke flavourings are products which can be added to foods to give them a "smoked" flavour, as an alternative to traditional smoking.
EFSA says it "cannot rule out concerns" about a flavouring called Primary Product AM 01, which is obtained from beech wood.
The wood particles are burnt under controlled conditions and the hot vapours are dissolved in a solvent.
The Panel says the use of the substance "at the intended levels is a safety concern".
Safety
Klaus-Dieter Jany, the chair of EFSA's expert panel on flavourings (CEF Panel) said: "The Panel based its conclusions on the limited data which are currently available as well as conservative - or cautious - intake estimates.
"The Panel expressed safety concerns for several smoke flavourings where intake levels could be relatively close to the levels which may cause negative health effects.
"However, this does not necessarily mean that people consuming these products will be at risk as, in order to be on the safe side, the consumption estimates deliberately over-estimate intake levels."
A spokesperson for the Food and Drink Federation which represents smoked food manufacturers said: "We shall be working with FSA and the European Commission in the coming weeks to consider how smoke flavourings may continue to be used safely, noting EFSA's previous statements in respect of smoke flavourings that their safety is relatively high compared to traditional smoking methods." - BBC News

European Food Safety concerns: http://www.efsa.europa.eu/en/press/news/cef100108.htm

I do not see anything that convinces me that liquid smoke is completely safe to use.

The GAPS Protocol

The GAPS protocol - blogpost by Judy Tsafrir, MD

The GAPS protocol was devised by a Russian physician, trained both as a neurologist and nutritionist, Dr. Natasha Campbell-McBride.
She had a son who suffered from symptoms of autism. When she could get no adequate help from conventional medicine for her child, she began an impassioned quest to find a treatment for him.

She developed the GAPS protocol, a system of diet, supplementation and detoxification. Her son is now a well-functioning individual. Dr. Campbell-McBride has a clinic in Cambridge, England, where she successfully treats thousands of children and their families as well as adults who are suffering from autism, depression, mood disorders, psychotic disorders, learning disabilities, dyslexia, dyspraxia, and increasingly all sorts of auto-immune, digestive, neurological disorders and rheumatological disorders. Her ideas are an elaboration of a protocol devised by Elaine Gottschall, who wrote The Specific Carbohydrate Diet.

Dr. Campbell-McBride wrote a book called The Gut and Psychology Syndrome, from which the acronym GAPS derives. The premise underlying her ideas, is that health and degenerative disease are based primarily upon digestive disorders stemming from an imbalance of intestinal flora, which results in damage to the wall of the intestine. This allows both for particles of food, microflora and their toxins to diffuse into the blood stream causing inflammation via auto immune reactions, as well as malabsorption of nutrients.

The cornerstone of the protocol is a nutrient dense diet, consisting of

• grass fed animal fat and protein,
  
• eggs,
  
• fish,
  
• fermented dairy,
  
• organic vegetables,
  
• fruits, and
  
• nuts.
  

All processed and store bought foods are avoided, as are all grains, starches, sugar, soy and unhealthy highly processed and refined vegetable oils.

There is both an Introductory Phase of the diet, which is more restrictive in order to efficiently and speedily promote healing and sealing of the intestinal wall. In some individuals it is then followed by a longer restorative phase where the dietary choices are far greater, the Full GAPS Diet.

Depending upon the symptoms, many people can begin the treatment with the Full GAPS Protocol, skipping the Introductory Phase. Dr. Campbell-McBride estimates that for many people it is necessary to follow the GAPS protocol for a minimum of two years in order to reclaim their health. She has recommendations for transitioning back to a non GAPS diet at the end of that period.

Dr. Campbell-McBride also recommends

• supplementation with high quality whole foods,
  
• both fish and cod liver oils,
  
• a good seed-nut oil blend,
  
• therapeutic strength probiotics and
  
• fermented foods and
• digestive enzymes.
  

In a year if symptoms persist, diagnostic testing can indicate the addition of targeted specific vitamin and mineral supplementation.

Detoxification and life style changes are also a part of the protocol.

• Juicing,
  
• detox baths and
  
• sunbathing and
  
• enemas are recommended, as is attention to take steps to reduce the toxic load in the environment.

Dr. Campbell-McBride has made a wealth of information about the GAPS protocol readily available on her website. As she wishes to provide a solution to our current nutritional and toxic public health emergency, and that an individual can safely and effectively implement the GAPS protocol on their own, she has provided all the necessary information to successfully do so.

Included on the website are detailed instructions about the protocol, lists of foods that are allowed and to be avoided, recipes, frequently asked questions and recommendations for supplements.

Starting in the summer of 2011 Dr. Campbell-McBride began holding workshops around the USA to train practitioners in her method. She recently held a training outside of New York City in the end of September, which I attended. At the end of her tour, there will be 120 Certified GAPS Practitioners in the USA. A list of Certified Practitioners will be available on her website by November 2011.

Hope for treating autism, psychiatric/neurological/auto=immune conditions

Adventures in Holistic Adult and Child Psychiatry

Judy Tsafrir, MD
Holistic Psychiatry

"One only sees what one looks for, one only looks for what one knows." - Goethe

Dr. Natasha’s Army

Home » » Blog » Dr. Natasha’s Army

Last weekend I attended a GAPS Practitioner Certification workshop outside of New York City with 40 other health care providers. There were naturopaths, osteopaths, nutritionists, occupational therapists, homeopaths, a holistic nurse, a woman in preventative dentistry, chiropracters, acupuncturists, in short, alternative health care practitioners of every stripe. Only four of us were physicians, two neurologists, one pediatrician and me. It was the most exciting conference that I have been to in years. Maybe ever.

Since late September Dr. Natasha Campbell-McBride, a Russian born neurologist and nutritionist, has been traveling around the United States with her fiercely protective English husband, Peter, who manages the business aspect of her work. She has been teaching workshops in Seattle, Chicago, and New York. The next one will be in Dallas following The Weston Price Wise Traditions Conference in November. The purpose of these workshops is to train people in her GAPS (Gut and Psychology Syndrome) Healing Nutritional Protocol, to carry her work out into the world.

Dr. Campbell-McBride has a clinic in Cambridge, England where she sees and helps thousands of patients who come to her from all over the globe. The demand for the treatment modality that she has developed is overwhelming and rising, and she now feels that she cannot do it alone. Early next year she plans to train practitioners in Australia. Though Dr. Campbell-McBride describes the GAPS nutritional protocol as essentially a self-help program, she believes that there are large numbers of GAPS people who need help and guidance from a qualified health care practitioner who is GAPS trained.

Dr. Campbell-McBride is a warm, down to earth open woman, with a charming accent, who has immense knowledge about the body, healing, food, conventional medicine, and folk medicine traditions. The breadth and depth of her wisdom, understanding and experience of illness and health throughout the life span is totally impressive and amazing. It is obvious that she is a consummate clinician.

With the method that she developed originally to help her autistic son, she has treated a vast range of conditions; psychiatric, neurological, and auto-immune. (She does not treat cancer.) Conditions as seemingly diverse as ulcerative colitis, autism, endocrine and rheumatological conditions, ADHD, bipolar disorder, epilepsy, eczema, eating disorders, osteoporosis, chronic fatigue, multiple sclerosis, PMS, infertility, to name just a few, respond to her method. Fundamentally all of these conditions link back to the same etiology, gut dysbiosis, which affects a patient’s nutritional status and immunity. She believes that many conditions that are designated “genetic” are not genetic at all, but rather a function of the imbalanced gut flora, which has been passed down from parents to baby. The baby has the same microflora and thus the same symptoms as his parents. She is working on a new book with the same GAPS acronym, which stands for The Gut and Physiology Syndrome, which addresses conditions with symptoms that are not primarily psychological, but equally due to dysbiosis.

So much of what she had to say flew in the face of conventionally accepted medical practice. Her recommendations are not based upon double blind placebo controlled studies, but rather upon her vast clinical experience. She knows what works and heals. Patients recognize that what she has to offer is effective, and she is simply inundated with referrals.

GAPS patients are frequently people who have been told that there was nothing that could be done for them. All that could be offered were drugs that caused major adverse side effects to palliate their symptoms, or recommendations for drastic surgical interventions. They arrive at Dr. Campbell-McBride’s clinic as a last resort, and the relief is enormous when they finally get the help they desperately need for themselves and their children.

Dr. Campbell-McBride does not prescribe toxic pharmaceuticals or recommend invasive procedures. The approach is refreshingly low tech and natural. Her method does not aim to suppress and palliate symptoms, but rather goes to the common heart of myriad conditions. The goal is to restore health and balance to the body through intelligent nutrition with a whole foods diet high in healing animal fats. She recommends the avoidance of all grains and sugars, permitting only carbohydrates that are metabolized to monosacharrides and thus do not feed the harmful microflora, the avoidance of all processed and refined foods, and natural targeted supplementation and repopulation of the gut flora with therapeutic strength probiotics and fermented foods.

Also key are a variety of natural detoxification measures such as juicing, baths, enemas and sunbathing, which are so necessary in our very toxic modern world. She recommends the avoidance of all conventional personal care and house cleaning products. For autistic children she considers it essential to initiate the ABA educational method as soon as possible. She recommends finding an ABA consultant through CARD (The Center for Autism and Related Disorders) an organization in San Diego.

I imagine that many of my future blog posts will be based upon the pearls of clinical wisdom that she imparted to us during the workshop. The material was fascinating and highly practical. Each of us was provided with a thick practitioners manual with additional information not found in her book, The Gut and Psychology Syndrome. By the end of the month there will be a forum on her website for practitioners to talk to one another, to ask questions and report experiences. Support and sharing with other practitioners employing the same healing protocol will be crucial. There will a list on her website of the 120 newly Certified GAPS Practitioners in the United States.

At the end of the workshop, she gestured to us with a sunny smile on her face and lightheartedly said ” You are my army”.

I have never fancied myself a soldier. It does not fit my self concept at all, but it felt different coming from her. Probably part of my conviction has to do with the fact that I myself have suffered with digestive issues for all of my 55 years. I have sought many treatments, both conventional and alternative. None of them ever helped me, before I began the GAPS treatment protocol 6 months ago. Many psychiatric and medical illnesses plagued multiple members of my family, most of whom are now dead. The dysbiosis hypothesis is like a rosetta stone, which unlocks the mystery of how their diverse and myriad debilitating conditions all had a common etiology.

So far I have used the GAPS approach with only 5 or 6 patients in my practice, but all with good result. Several have been able to come off their psychotropic medications. These patients have all been adults with mood and anxiety disorders. Not many patients in my current practice have been willing to make the radical life style changes required by the GAPS protocol. I imagine that in time, patients will come to me specifically for my GAPS expertise.

When I was at Earlham College in the mid 70′s I studied the philosophy of science. I was very impressed with a book about the history of scientific revolutions. The author described scientific theory as a suitcase that was intended to be filled with data, and needed to be able to accommodate all of it. If information was discovered that did not fit the theory, data would be hanging out of it and eventually the suitcase would no longer close properly. A new more capacious theory would need to be invented. Dr. Campbell-McBride’s theory is a very big elegant suitcase, and I am repeatedly awed by how much it accommodates.

Dr. Campbell-McBride struck me as a modest woman. There was nothing in her demeanor that suggested grandiosity, that this was for the greater glory of Natasha. It was clear to me that her mission was about transmitting the remarkable gift of her methodology to those in need.

She belongs to that group of inspiring passionate people like Steve Jobs, Al Gore or Jimmy Moore. (Oprah would be on that list, but I am very disappointed in her destructive promotion of Mehmet Oz) Courageous mavericks who make their voices heard, and who use their gifts and abilities to make our troubled world a better place.

Here is something I love. Its the text and the video from the THINK DIFFERENT advertisement campaign for Apple Computers in 1997.

“Here’s to the crazy ones. The misfits. The rebels. The troublemakers. The round pegs in square holes. The ones who see things differently. They’re not fond of rules. And they have no respect for the status quo. You can quote them, disagree with them, glorify or vilify them. About the only thing you can’t do is ignore them, Because they change things. They push the human race forward. And while some may see them as the crazy ones, we see genius. Because the people who are crazy enough to think that they can change the world, are the ones who do.”

Here is the video.