Monthly Archives: January 2011 - Page 4

Water Weight: Does It Change When Changing Diets? Does It Matter?

Posted by on January 14, 2011 54 comments

We’re now up to the final topic in the series reviewing experiences on the diet. Our final topic is the issue of weight gain and loss. This will take a few posts to explore. Next week will be “fat loss week.” This week, let’s look at the question of water weight.

Overweight people who come to the Perfect Health Diet from a high-carb diet seem to lose weight from the beginning. Here is a recent comment from Robert:

I started PHD a few weeks ago, after finding the blog, and then reading the book. I have only positive experiences to report…. I had been overweight in the past, and lost weight by low-calorie dieting on processed foods, along with strength training. After a while I would revert to some degree of overeating, and have to diet again. I’m mildly overweight now but I have been losing 2 lbs. per week on the PHD. Keep in mind this is before any calorie counting. I keep telling myself I will plug things in to Fitday, but so far my hunger is autoregulating itself and the weight is coming off.

However, some of our readers who came from very low-carb diets experienced immediate weight gains. One commenter on Amazon seemed to think this experience would be universal:

[I]f you are coming to the diet from a zero-carb or very-low-carb regimen, you can count on an immediate and substantial weight gain if you suddenly adopt the recommended intake of “400 carb calories [100 grams] per day of starchy tubers, rice, fruit, and berries.” (K. Hix)

Commenter Maggy reported a gain of 5 pounds in her first week:

Following your advice, I added back a bit of “safe starch” last week, and decreased protein intake, keeping sat fat and MCF pretty high. Well, I got on the scale today and have managed to put on 5 pounds! I’m trying to figure out what is going on and what I need to tweak. I do need to lose a good 20-30 lbs, and while I don’t want to compromise health, I also don’t want to put back on what I managed to lose doing a VLC diet.

Is this an adjustment period I need to get through? Maybe I’m one of those broken metabolism folks who has to stick with VLC?

Commenter Bill also experienced a quick gain of a few pounds, and wondered if it could be due to water weight:

After experimenting with adding modest amounts of “safe starches” to my much lower-carb routine, I have noticed a modest weight gain of 3-5 lbs. I wonder if it’s merely glycogen and water repletion.

Beth Mazur of WeightMaven.org agreed:

I also wouldn’t be surprised about weight gain. Presumably these folks are normally running on fairly low glycogen stores. Add some starchy carbs back, and the resulting water weight gain could be a handful of pounds presumably.

That’s an interesting question, so I thought I’d look into the matter.

Background: Glycogen, Glycoproteins, and Water Weight

Sugars are hydrophilic. If you put some water next to some sugar, the sugar will soak it up. As a result, a person’s water weight depends in part on the weight of sugars in the body. More sugars, more water, more weight.

It’s commonly stated that each gram of glycogen is associated with four grams of water; let’s take that as a general ratio for organic sugars.

A typical adult has around 500 grams of glycogen, roughly one-third in the liver and two-thirds in muscle. With associated water, this would add about 2.5 kg or 5 pounds to body weight.

But there are also several pounds of glucose in glycoproteins throughout the body:

  • Mucus in the digestive tract and airways may be as much as 80% sugar by dry weight.
  • The glycocalyx, a protective polysaccharide coat around cells, is primarily composed of sugars.
  • Hyaluronan, glucosamine, and other compounds that enable joints to move freely have much of their weight as sugar-water associations.

These sugar-containing molecules with their associated water add a lot of weight to the body. Glycogen we’ve said accounts for as much as 5 pounds; mucus probably accounts for several pounds at least; and other glycoproteins must add at least a few pounds more.

Are Glycogen and Glycoproteins Lost on a Low-Carb Diet?

It’s commonly asserted that much of these sugar-containing molecules, and their associated water, are lost on a low-carb diet. From a review of Gary Taubes’ Why We Get Fat, linked today by CarbSane:

[B]etween 5-10lbs of weight are lost on a low-carb diet due to the mobilization of the water stored with glycogen …

I argued in my “zero-carb dangers” series that a danger of zero-carb dieting was that the body would downregulate production of glycoproteins; and that reduced production of these might be quite dangerous.

For instance, reduced production of mucus in the digestive tract might increase the risk of gastrointestinal cancers, bowel diseases, and entry of infectious pathogens through the gut.

If it’s true that low-carb diets reduce water weight by 5 to 10 pounds, there must be a substantial loss of sugar-containing molecules. This is hardly likely to be healthy. Glycoproteins are essential for good health. Indeed, the evolution of glycoproteins was a prerequisite for the evolution of multicellular life!

So I would find this kind of water-weight loss quite alarming.

Let’s look for some data to see if it actually happens.

From High-Carb Diet to Fasting

In our earlier post on fasting for migraines, commenter js290 linked to a very nice post by Ned Kock, in which he talked about the components of weight loss during starvation. Ned posted this picture, taken from a textbook [1]:

Over 30 days of fasting, almost half the weight lost is from fat and almost half from water; small amounts of protein and sugar are lost.

In the first few days, water loss dominates. In the first 48 hours, 3.4 kg are lost, of which roughly 0.35 kg are glycogen, 0.1 kg protein, 0.3 kg fat, and 2.65 kg water.

So in the first two days of fasting, fully 5.8 pounds of water are lost. That’s remarkable.

Presumably, if this person had been returned to his normal diet, that weight would have been regained in a few days.

If the water loss was triggered by a loss of carbohydrate (in glycogen and glycoproteins), then a very low-carb diet might have had the same effect as the fast.

From High-Carb to Low-Carb Diets

There are some metabolic ward studies looking at what happens when people adopt low-carb diets. Here’s one that looked at an Atkins-style diet. [2]

The subjects entered the metabolic ward but continued to eat their normal diet on days 1 through 7, to provide a baseline. Then they adopted an Atkins-style diet for 2 weeks. Carbohydrate was reduced to 21 g (80 calories) per day, and they could eat as much fat and protein as they wished.

The results:

During the low-carbohydrate diet, mean body weight decreased by 2.02 kg from 114.43 kg (last day of the usual diet) to 112.41 kg (last day of the low-carbohydrate diet) …

During the low-carbohydrate diet, mean body water decreased from 46.30 kg to 45.94 kg. Body water decreased in 6 patients, increased in 3 patients, and did not change in 1 patient. After subtraction of body water, mean body weight decreased from 68.13 kg to 66.48 kg. [2]

In other words, water weight hardly changed. The weight loss was accounted for by fat loss, which was understandable because the subjects reduced their calorie intake by 946 calories per day. [2]

So in this study, water weight loss averaged only 360 g (0.8 lb), and some patients actually gained water weight on the low-carb diet!

So it looks like going from a high-carb diet to a low-carb diet needn’t lead to much loss of water weight.

From Low-Carb Diet to Fasting

I looked for some papers on what happens when a low-carb dieter starts a fast. I found this:

In her book ‘Living on Light’, Jasmuheen tries to animate people worldwide to follow her drastic nutrition rules in order to boost their quality of life. Several deaths have been reported as a fatal consequence. A doctor of chemistry who believably claimed to have been ‘living on light’ for 2 years, except for the daily intake of up to 1.5 l of fluid containing no or almost no calories was interested in a scientific study on this phenomenon.

The 54-year-old man was subjected to a rigorous 10-day isolation study with complete absence of nutrition. During the study he obtained an unlimited amount of tea and mineral water but had no caloric intake….

[The man experienced] a mean weight loss of 0.26 kg/d … [3]

If his weight loss of 260 g/day consisted of 130 g protein and 130 g fat – a plausible mix – then he was expending about 1700 calories per day. This is very plausible, and leaves little room for water weight loss.

So when a low-carb dieter starts a fast, he may lose hardly any water weight at all!

Summary and My Own Experience

These studies are inconsistent. If going from a high-carb diet to a low-carb diet doesn’t produce water weight loss, and going from a low-carb diet to fasting doesn’t, then why would going from a high-carb diet to fasting?

I confess I was surprised by the level of water loss reported by Ned’s source. I fast moderately often, and I lose typically around 1 pound during a 36 hour fast. Shou-Ching’s experience is similar. That doesn’t leave much room for water weight loss.

But clearly, some people do experience large losses of water weight when they adopt a low-carb diet or a fast, and then regain it upon carb re-feeding.

I think we have to conclude that the phenomenon of water weight loss on low-carb diets, and water weight gain on carb re-feeding, is variable across persons. In some persons it happens, and in others it doesn’t.

Conclusion

I think those sugars serve important functional purposes. Glycoproteins are essential for health. Glycogen is a desirable reserve that helps the liver manage blood glucose and muscles exert force.

Maggy asked if she was metabolically broken because she gained 5 pounds in a week by adding carbs back in. Now, a lot can happen in a week, including significant changes in fat and protein mass, and water weight changes due to changes in sodium levels. Low-carb diets tend to lead to salt loss, so that may have been a factor.

But if the weight gain was entirely due to restoration of sugar and water levels, then I’m reluctantly led to the conclusion that Maggy may indeed be “metabolically broken.” The brokenness is not in the gain of bodily sugars when she eats the carbs; it’s in the loss of these important sugars on her very low-carb diet!

If it’s unhealthy to lose those sugars, and if a metabolically healthy person can sustain the body’s sugar and water levels through a fast, then the loss of sugars on either a low-carb diet or fast suggests a damaged metabolism.

As much as Maggy wishes to lose weight, it is important to lose weight from adipose cells, not from water and glycoproteins. Her rapid ~5 lb weight gain upon shifting from a very low-carb diet to the Perfect Health Diet might have been a very good thing.

UPDATE:

CarbSane has begun a series on water weight, and has interesting numbers on water weight in adipose tissue and lean tissue, and how water weight varies between obese and lean persons. This post introduced several papers, and a follow-up contributes an interesting analysis and suggests that movement of fatty acids between adipose and lean tissue may be involved in water weight changes.

I didn’t know that extracellular water weight in tissues was so variable. Thank you CarbSane! 

References

[1] Wilmore, J.H., Costill, D.L., & Kenney, W.L. (2007). Physiology of sport and exercise. Champaign, IL: Human Kinetics. Cited by Ned Kock, “The amounts of water, carbohydrates, fat, and protein lost during a 30-day fast,” http://healthcorrelator.blogspot.com/2010/10/amounts-of-water-carbohydrates-fat-and.html.

[2] Boden G et al. Effect of a low-carbohydrate diet on appetite, blood glucose levels, and insulin resistance in obese patients with type 2 diabetes. Ann Intern Med. 2005 Mar 15;142(6):403-11. http://pmid.us/15767618. Full text: http://www.annals.org/content/142/6/403.full.pdf.

[3] Heusser P et al. Nutrition with ‘light and water’? In strict isolation for 10 days without food – a critical case study. Forsch Komplementmed. 2008 Aug;15(4):203-9. http://pmid.us/18787329.

What’s the Trouble With Sweet Potatoes?

Posted by on January 11, 2011 166 comments

We’re continuing with a series on people who have reported something going wrong when they tested some variation of the Perfect Health Diet. (The first post summarized experiences, good and bad; the second looked at difficulties suddenly adding carbohydrates to a very low-carb diet.)

The next issue was reported by Chris Masterjohn; he had trouble with sweet potatoes:

Although sweet potatoes are considered a safe starch on the Perfect Health Diet, they are not very safe for me. When I discovered how yummy sweet potato fries are, I started eating several sweet potatoes per day. Within a few days, I was limping and my neck was stiff. By the end of the week, my limp was extreme. I looked online to see if I was eating anything high in oxalates, and sure enough, sweet potatoes are loaded with them. My symptoms dramatically improved after one day off sweet potatoes and were gone the second day.

Chris’s commenter Lisa also had trouble with sweet potatoes:

I’ve been very achy since I started eating sweet potatoes daily. Why would some of us be maladapted to oxalates?… I’m wondering if after a long stint of LC/paleo eating I’ve become intolerant to oxalates or to starch in general.

Clearly sweet potatoes are not safe for everyone. What might be causing the trouble?

Fructose and Fiber as Possible Confounders

One factor to consider is that there are different varieties of sweet potato. We eat an Asian sweet potato variety which is not nearly as sweet as conventional American sweet potatoes; it has a yellow flesh and a chestnut flavor. It is botanically a yam, not a sweet potato. It looks like this (via “my super sweet twenty-six”):

Like so many modern foods, the standard American sweet potato has been bred for sweetness. Here is data from http://nutritiondata.com comparing 100 g of potatoes, yams, sweet potatoes, and grapes for sugar, starch, and fiber content:

Food Sugar (g) Starch (g) Fiber (g)
Potato 1.2 17.3 2.2
Yam 0.5 23.1 3.9
Sweet potato 6.5 7.5 3.3
Grapes 15.5 0.0 0.9

All have similar calories. Yams are largely sugar-free, but sweet potatoes are intermediate between grapes and potatoes in both sugar and starch content. They are sort of half fruit, half starch.

Thus, it is conceivable that sweet potatoes could trigger an issue like fructose malabsorption; or that fructose or fiber might feed certain gut infections that would not be similarly fed by potatoes.

Oxalate

Chris believed his problem was due to oxalate. Sweet potatoes do contain oxalate, although they are not the only plant foods which do.

In fact, by far the largest source of oxalate in the American diet is spinach. Spinach by itself accounts for over 40% of all oxalate consumed by Americans; potatoes for about 10%. [1] Wheat bran has high levels of oxalate.

Why are oxalates troublesome?  Some people have sensitivities to oxalate. Rarely, genetic defects in the enzymes that degrade oxalate cause a disease called primary hyperoxaluria; this disease afflicts 1 to 3 people in a million.  Other conditions can elevate calcium or oxalate in the urine and increase the risk of calcium oxalate kidney stones. This is especially likely in people who are deficient in magnesium or who don’t eat citrate. [2]

Another pathway by which oxalate might cause trouble is via fungal infections. Candida and other fungi form calcium oxalate crystals in tissue [3,4]; fungi appear to be responsible for the yellow-brown calcium oxalate biofilms which form on stone monuments. [5]

But the literature suggests that oxalate sensitivities are rare. If oxalate sensitivity is present, then it should manifest itself when eating spinach, wheat bran, and other oxalate rich foods. Since Chris has praised spinach and wheat recently, I wonder if it is really the oxalate that caused his trouble.

Phytoalexins

Another possibility is a class of toxins called phytoalexins.

Ordinarily, sweet potatoes are largely toxin free. But when attacked by fungus or molds, sweet potatoes generate a variety of food toxins. As two papers describe them:

Sweet potatoes contain phytoalexins that can cause lung edema and are hepatotoxic to mice. At least one of these, 4-ipomeanol, can cause extensive lung clara cell necrosis and can increase the severity of pneumonia in mice. Some phytoalexins in sweet potatoes are hepatotoxic and nephrotoxic to mice. [6]

Ipomeanine (IPN), 4-ipomeanol (4-IPO), 1-ipomeanol (1-IPO), and 1,4-ipomeadiol (DIOL) are toxic 3-substituted furans found in mold-damaged sweet potatoes. IPN and 4-IPO are the most toxic, but all produce pulmonary toxicity in cattle and rodents, and 4-IPO induces hepatotoxicity in humans. [7]

Cattle will die if fed mold-damaged sweetpotatoes:

Unfortunate bovine fatalities occurring after ingestion of mold-damaged sweetpotatoes preclude the use of the culled tubers in livestock feed. In cattle, mold-damaged sweetpotatoes induce an acute respiratory distress syndrome resulting in asphyxiation. [8]

Toxins may be present even if mold damage is not visible:

Fermentation of 6 weeks duration was observed to inadequately eliminate the lung, liver, and kidney toxicity caused by mold-damaged sweetpotatoes. In fact, fermentation exacerbated the hepatotoxicity of mold-damaged sweetpotatoes. This is also the first demonstration that sweetpotato regions lacking visible mold damage can induce lung and kidney injury … [8]

Allergies

Sweet potatoes are generally considered to be one of the least allergenic of foods. However, infants sometimes do have sensitivities to sweet potato. This may reflect an immature gut flora in the infants; perhaps specific bacterial species — possibly including the oxalate-digesting Oxalobacter [9] — make sweet potatoes tolerable? If so, it raises the possibility that adults with incomplete gut flora might also have sweet potato sensitivities.

There is also the possibility of allergies to mold toxins in infected sweet potatoes.

Food Sensitivities as a Diagnostic Tool

Food sensitivities can sometimes be helpful in diagnosing certain health conditions:

  • Leaky gut. People with a leaky gut will have many food sensitivities; people with a healthy gut will have few.
  • Small bowel infections. People with infections of the small intestine will usually have a negative reaction to fructose.
  • Colonic infections. People with infections of the colon may react badly to fiber, and obtain relief on low-fiber diets.

There is a chance that oxalate may benefit fungal infections, so I suppose an oxalate sensitivity could be diagnostic for that, although in my experience fungal infections are usually slow-reacting to food and the response is rarely obvious.

Conclusion

In our book [p 121] we note that all plants make pesticidal toxins. Thus, no plant food can be guaranteed to be safe.

Normally, levels of pesticidal toxins are low in sweet potatoes. But it’s always desirable to inspect sweet potatoes for visible damage, and to discard any that are discolored or show other evidence of toxin production.

I confess to being puzzled as to how sweet potatoes caused Chris’s symptoms. If he tolerates spinach and wheat bran, it seems unlikely that the oxalate in sweet potatoes would be responsible. He might wish to test various foods and try to narrow down the source of his sensitivity.

For our part, we may cease listing sweet potatoes among our “safe starches” and specify yams instead, since a “safe starch” should probably be low in fructose.

References

[1] Taylor EN, Curhan GC. Oxalate intake and the risk for nephrolithiasis. J Am Soc Nephrol. 2007 Jul;18(7):2198-204. http://pmid.us/17538185.

[2] McConnell N et al. Risk factors for developing renal stones in inflammatory bowel disease. BJU Int. 2002 Jun;89(9):835-41. http://pmid.us/12010224.

[3] Takeuchi H et al. Detection by light microscopy of Candida in thin sections of bladder stone. Urology. 1989 Dec;34(6):385-7. http://pmid.us/2688263.

[4] Muntz FH. Oxalate-producing pulmonary aspergillosis in an alpaca. Vet Pathol. 1999 Nov;36(6):631-2. http://pmid.us/10568451.

[5] Pinna D. Fungal physiology and the formation of calcium oxalate films on stone monuments. Aerobiologia. 1993 9(2-3):157-167. http://www.springerlink.com/content/n72l71352t1r0r04/.

[6] Beier RC. Natural pesticides and bioactive components in foods. Rev Environ Contam Toxicol. 1990;113:47-137. http://pmid.us/2404325.

[7] Chen LJ et al. Metabolism of furans in vitro: ipomeanine and 4-ipomeanol. Chem Res Toxicol. 2006 Oct;19(10):1320-9. http://pmid.us/17040101.

[8] Thibodeau MS et al. Effect of fermentation on Sweetpotato (Ipomoea batatas) toxicity in mice. J Agric Food Chem. 2004 Jan 28;52(2):380-4. http://pmid.us/14733525. B76FN5FG89GM

[9] Hatch M et al. Enteric oxalate elimination is induced and oxalate is normalized in a mouse model of Primary Hyperoxaluria following intestinal colonization with Oxalobacter. Am J Physiol Gastrointest Liver Physiol. 2010 Dec 16. [Epub ahead of print]. http://pmid.us/21163900.

Homemade Seasoned Seaweed

Posted by on January 9, 2011 30 comments

Most Americans, if they ever tried seaweed at all, probably gave up on it after the first try because it is either very tough (kelp) or bland (nori).

However, well-prepared seaweed can be very tasty as well as extremely nutritious.

Korean Seasoned Seaweed

Koreans have developed a wide menu of tasty seaweed snacks. The basic strategy is to soak seaweed in oil, season it, and bake it briefly. The oil and seasonings make the seaweed taste much better.

The only trouble is that, like most food products sold in this country, commercial varieties tend to use low-quality oils. On our supplement recommendations page, we mistakenly linked to some Korean seasoned seaweed products that used unhealthy oils – canola oil or corn oil. (We’ve since corrected that; the current versions use olive oil and sesame oil.) Commercial varieties are also unreasonably expensive (in our view).

But seasoned seaweed is very easy to make at home. Today we’ll show you how.

Ingredients

First, get some nori – the classic Japanese sushi seaweed. In Korea, seasoned seaweed is made from unroasted seaweed, but we used roasted nori and it worked just fine. Here’s what we used:

The sheets are about 8” by 8”. You’ll also need:

  • A healthy, low-omega-6 oil. We used olive oil on some sheets and coconut oil on others. Next time, we’ll try beef tallow and clarified butter.
  • Seasonings. We used sesame oil and sea salt.

Here was our work area:

Spread the healthy oil on the seaweed. Each sheet will require about 1/2 to 1 teaspoon of oil (dried seaweed can really soak up oil). We favor using the back of a spoon to spread the oil.

Sprinkle the salt (and any other seasonings) on the seaweed:

Place a new sheet on top of the previous one and repeat the application of oil and seasoning. It will pick up some oil and salt from the sheet underneath. In this photo, we’re applying coconut oil:

When you’ve finished your whole stack of sheets, place a few sheets on a baking sheet and bake at 350 degrees Fahrenheit (175 Celsius) for 2 minutes:

We baked each sheet individually, but it might be possible to bake a whole stack at once — we’ll try that next time.

The baked sheets may be easily folded and torn into more convenient sizes:

Here’s a finished stack:

Voila! Just like grandma in Korea makes it. Eat the seaweed alone or with rice.

Chris Kresser’s Paleo Detox Program

Posted by on January 8, 2011 7 comments

Occasionally readers email us and ask if we do health consultations for an hourly fee. We don’t. (We do our best to respond to questions however.)

We’re happy to refer those looking for advice to Chris Kresser, who recently launched his own alternative medicine practice. We have great confidence in Chris.

Chris has created a service called the “Paleo Detox Program.” Here is a video in which he describes the program:

The program starts in February. Here is a link to register: