Around the Web; and How to Shop for Salmon Cakes

Some interesting items this week:

(1) Peter’s back! And with a very interesting post about dogs with diabetes. One highlight:

[I]nsulin is normally produced by the pancreas and it travels directly to the liver. There is first pass metabolism by the liver, lots of it. The liver extracts between 50% and 80% of all of the insulin produced by the pancreas. Relatively little ever gets to the systemic circulation. This residue is what should be controlling adipocyte function.

This is why injected insulin is not as healthful as natural insulin – it acts too strongly on the rest of the body, not strongly enough on the liver. And it is why diabetics should eat a low-carb diet.

(2) In the comments, Doug linked to a 2009 paper [1] showing that eating blueberries with milk reduced the absorption into the body of the blueberry phenolics caffeic and ferulic acid. Doug wanted to know if this should cause him to stop eating his blueberries with cream.

I don’t think so! The greatest benefits from these berry compounds seems to come in the gut, where they act as toxins to pathogens and help promote beneficial gut flora. So if milk reduces their absorption, it must be increasing their presence in the gut.

Entry of these compounds into the body might even be harmful. Peter recently discussed two potential mechanisms by which berry compounds might be harmful: inhibition of the enzyme CETP, like the drug anacetrapib; and antioxidant activity which, paradoxically, increases oxidative stress by downregulating the body’s own natural antioxidants.

It’s hard to beat the delightful taste of berries and cream. Luckily this study gives us no reason to avoid them!

(3) A new study finds that vitamin A and mimics, such as the anti-acne drug Accutane, greatly amplifies inflammation in the bowels of people with food sensitivities. [2] This may be another reason not to supplement vitamin A.

(4) Kurt Harris offers a good breakfast tip for those who like cereal:

Rice Krispies have no added sugar. It’s just toasted white rice. A good sized bowl is maybe 40 g of starch, plus whatever lactose if you add H/H or milk.

(5) Melissa McEwen  passes on from Kathryn Clancy the news that anemia is usually a sign of internal bleeding:

Iron-deficiency is not something you get just for being a lady: … Almost all doctors seem to think that iron-deficiency is part of being a woman, but that doesn’t make sense evolutionarily. Turns out, it’s no normal and doctors who think it is often miss the true cause, which is internal bleeding. 

When I was a freshman college I had iron issues. Just like in the post my doctor gave me iron pills, which absolutely destroyed my stomach. Finally a better doctor found out I had a GI bleed. Now why do so many people get GI bleeds? In my case it was from taking NSAIDs, which is a fairly common cause.

(6) Across countries, higher disease burdens are associated with lower IQ. Here is a plot from Bill Gates’s annual letter:

There are many possible causes for this correlation, but none of them suggest it’s good to get a lot of infections.

(7) Jenny Ruhl tells us that colas – whether diet or sugared, it doesn’t matter – damage the kidneys and increase stroke risk. The culprit may be phosphoric acid.

(8) The New York Times reports that loneliness eliminates the benefits of exercise. You need to be sociable as well as athletic to achieve good health!

(9) Finally, our video of the week. Matt Brody enjoyed Rachel Albert’s salmon cake recipe. He used canned salmon, which reminded me of this classic advertisement: 


[1] Serafini M et al. Antioxidant activity of blueberry fruit is impaired by association with milk. Free Radic Biol Med. 2009 Mar 15;46(6):769-74.

[2] Depaolo RW et al. Co-adjuvant effects of retinoic acid and IL-15 induce inflammatory immunity to dietary antigens. Nature. 2011 Feb 9. [Epub ahead of print]

Leave a comment ?


  1. That study about vitamin A in the intestine indicates that the inflammatory response occurs in a “stressed intestinal environment.” It would help if the abstract would specify which antigens they’re talking about. Vitamin A is too important in the diet for anyone to decide that it is more important to be able to eat beans and grains than it is to be able to see, to reproduce, and to bear children whose bodies work correctly.

    I supplement vitamin A from a fish liver oil source (not specifically cod liver oil but probably extracted from it). I make sure to pair it with D, usually 8000 IU of A and 5000 IU of D, because I don’t eat liver, don’t eat eggs every day, and it’s winter and I don’t do well in the cold, so I don’t go outside much. (It wouldn’t matter if I did; I’m too far north to benefit much from UVB.) Supplementing the A has meant that a three-year problem with excessively heavy periods resolved itself without surgery. Good thing too; I didn’t have health insurance at the time. Had I known all the roles vitamin A plays in the body I would have supplemented it in pregnancy also; my daughter was born with vesicoureteral reflux into both kidneys, and I have since learned that A is important in the signaling process involved with development of the ureteral bud, which is exactly where her birth defects occurred. She is now at increased risk of end-stage renal disease later in life even though the VUR has been corrected, so says a friend of mine who works in a transplant clinic.

    So… More information’s needed. Is it just the A by itself? Is it A in response to all antigens? Is it A not balanced properly with D (and maybe K2)? Because I’m not going to quit something that’s demonstrably made me healthier. Sorry.

  2. Hi Dana,

    Welcome! I’m glad to hear you’ve fixed periods by nutrition. So many health conditions can be fixed that way, and doctors and patients both overlook the opportunity.

    The paper in question was mainly concerned with wheat, but the cytokines in question appear in association with food sensitivities of all kinds, so it’s probably generalizable.

    Our book has a fuller discussion of the evidence regarding vitamin A. Briefly, we recommend a carotenoid-rich diet (egg yolks, beef liver, colorful vegetables, etc.) and a multivitamin which typically has a healthy amount of vitamin A.

    Various clinical trials have shown significant health impairments, including increased mortality, from vitamin A doses above 10,000 IU/day. Unfortunately, the research is insufficient to answer the other questions you raise at this time. We don’t know how the safe vitamin A intake would change if people were getting high levels of vitamin D, as you are. Clearly there are interactions.

    But, taking the evidence at face value, I think you want to eat foods that are rich in carotenoids / vitamin A, but should be cautious about high-dose supplementation of retinoic acid in fish oil.

    Best, Paul

  3. Rice Krispies ingredients, per [asterisks added]:


  4. Hi Steve,

    Thanks for doing the legwork!

    I suppose Kurt is buying some sugar-free toasted rice cereal. Or maybe his “Life Not Therapy” diet allows sugar.

  5. Paul, you are quite charitable in your hypotheses. Yes, earlier in his blog entry he referred to eating “generic rice krispies.” But later he says, “Rice Krispies have no added sugar.” “Rice Krispies” is a brand name, and some readers could be misled. That said, I doubt that the amount of sugar in a bowl of Kellogg’s (as opposed to generic) R.K. — 4g per 1 1/4 cups — would concern either of you.

  6. I’m amused and pleased. I’m happy to see Paleo movement folks accepting rice and a bit more carbs. I avoid sugar and I think it’s good to avoid it, but you’re right, a little bit isn’t likely to do harm. Though personally I would rather add some berries to a sugar-free toasted rice cereal.

    I predict that soon there will be so few differences between all our diets, the diet blogosphere will be one big happy family. 🙂

  7. Thankyou for addressing the issue of the berries Paul!

    I’m only a quarter of a way through it, but I’m thoroughly enjoying the book by the way!

  8. It totally amazes me that anyone could even entertain the idea that a few grams of sugar (only half of which would be fructose) could be of concern, when the SAD contains about 150 lbs a year of the stuff.

    Yes, I eat white rice, and sweet potatoes and white potatoes and the usual green veggies and salads. And the other week I ate a whole gluten containing thin crust pizza by myself. Then I smoked a few marlboro reds, had anonymous unprotected sex with loose women, knocked back some old granddad and finally took my Ducati for a spin with no helmet, and to top it off I didn’t even wear a warm jacket! My mom would be so upset!

    Yes, the generic rice krispies (krispy rice?) that I ate had no added sugar.

    Thanks for the link, Paul!

  9. It was the asterisks wot done me in.

    Meanwhile, my curiosity was piqued and I found this on the net in case someone wants to try some Crispy Brown Rice:

    Erewhon Organic Gluten Free Crispy Brown Rice Cereal

    Less than 1g sugar per cup. $45.56 for a 12-pack of 10 oz. containers. Loose women and Ducati not included.

    M’self, I plan to continue my standard breakfast of bacon, eggs, pico de gallo, cheddar cheese, and blueberries (really!) all mixed together and fried in the bacon’s grease.

  10. My take on the “nice graph”

    Disease Burden negatively associated Low I Q ……

    unless of course, it’s Parental I Q ?

  11. Hi Kurt,

    Welcome! I’m a fan of your blog and I’m pleased that our diets are almost identical. (Save for the Marlboro reds!)

    Hi Steve,

    Since I’ve started daily intermittent fasting, quite happily, my breakfasts (when I have them at all) are little more than a banana. But yours sounds great!

    Hi Leon,

    I’m not sure I follow your take, but parental IQ and child IQ are both correlated with disease burden.

  12. Paul – since you mention intermittent fasting – what I described is my standard breakfast every other day. On the preceding and following day I eat no breakfast and about 700 calories total. I’ve been doing this alternate-day regimen for a couple of years now.

  13. I was suggesting that good health results from high IQ, and disease burden from low IQ. The possible causation is other way round, by interchanging X and Y.

  14. ” . . .Then I smoked a few marlboro reds, had anonymous unprotected sex with loose women . . .”

    That was you??!!??

  15. Thanks Paul

    I see real convergent evolution just in the past few years- Paleo 2.0 where paleo means ancient, not paleolithic

    Independent folks converging on the same theme

    1) Lipid hypothesis is bunk

    2) Eat animals

    3) Limit the NAD – wheat fructose and linoleic acid

    4) Starches can be good

    5) No paleo-reenactment

    Harris, Jaminet, Kresser, Guyenet, Lalonde, McEwen, Masterjohn ( absent the wheat), J. Stanton, Peter, etc….

    There are probably others we don’t know of yet – I had not heard of you until just a few months ago. The similarities are striking and gratifying. I’ve bought your book but haven’t had time to read it yet. Looking forward to that for sure

  16. Hi Kurt,

    Thanks much! I do think everybody’s converging, and it is very gratifying.

    I think the science has become pretty solid and is driving us all to the same conclusions … but the professionals are too specialized to see the totality of the evidence! Definitely the evolutionary / ancient / wisdom-in-traditional-cultures perspective helps tremendously in getting to the truth quicker.

    I like your list of themes, but I have to say that I don’t really mind Pacific Islander diet re-enactment, especially if I get to visit the beaches at the same time. A luau, warm water, coral, and a tropical sunset sounds good this February …

    By the way, on Thursday I’m planning a riff on your “Therapy versus Life” post, from a chronic disease patient’s perspective. That was a thought-provoking post.

    Best, Paul

  17. Re: rice cereals, I’d skip the brown rice stuff, brown rice is apparently high in phytates which can block mineral absorption. Plus, In my humble opinion, white rice tastes way better.that said, I’m going back to my childhood breakfasts of warm cereal, trying out cream of rice, rather then cream of wheat, with cream and butter and apricot applesauce added.

  18. Paul, I had physical therapist come in to help with rehabing my new bionic knee and we had nice discussion about the PHD. She’s already off grains and eats more or less what you suggest. I gave her your website and I’m sure she’ll check it out.

    One by one, healthy people will conquer the world.

  19. Thanks, erp! Welcome back!

    I assume you look more like Lindsay Wagner than ever?

  20. … more like her grandmother, I should think.

  21. @Emily

    I’ve noticed the gluten free pizza flours (for pizza for the nephews, etc) often has brown rice flour in it. Puffed rice is good for breakfast as well. My cereal breakfasts come out to about 70% fat by calories from cream.

  22. @ Kurt

    Are you eating 100% puffed rice or one of those packaged breakfast cereals?

    In Australia it seems all the puffed rice that is not sold as a boxed breakfast cereal is made from brown rice. Not only that but the texture is spongy rather than crispy. The same goes for puffed rice cakes – all made from brown rice. I’m not concerned about eating a couple of rice cakes as they’re mostly air inside a little bit of rice. Two of them with a healthy serving of butter and liverwurst has become a favourite quick snack for me.

  23. Kurt, butter & liverwurst? Hmm, how decadent. :-}

  24. In re: to gluten-free products that are also low in phytates try the Gluten Free Pantry brand of all purpose flour, it’s made of white rice, potato, and tapioca starch in that order. My understanding is that tapioca does possibly have some phytates but it’s unknown how much?

    I have used blanched almond flour as a substitute but almonds with skins are apparently high in physic acid and other anti nutrients, perhaps as high as wheat flour, though gluten free. Skin less almonds may be less full of phytates but it’s a toss up. From what ive been reading, most cultures that have relied on food from starches from tubers, roots, or nuts, use complex processes to reduce the anti nutrients. Ie. Manioc of which some types are full of cyanide must be pounded, soaked, stained etc before they are edible.

  25. In response to Steve Brecher’s link, I’m wondering if anybody knows of good puffed rice products made with white rice. I notice almost all of them are made with brown rice.

    Also, Paul is it possible that you could allow people to subscribe to comments or at least replies to comments. I know of several wordpress plugins that do this. Here’s a link to one of them:

  26. Correcting my error above, phytic acid. Stupid auto correct

  27. Hi Rodney,

    I’ll work on that. Thanks for the suggestion.

    Best, Paul

  28. Paul wrote: “I’m amused and pleased. I’m happy to see Paleo movement folks accepting rice and a bit more carbs….I predict that soon there will be so few differences between all our diets, the diet blogosphere will be one big happy family.”

    It’s been feeling very much like that is the case lately with all of the warm comment and post fuzzies with you and Kurt and Emily and Kurt and on a very different level, Melissa and Chris. The supportive, interesting discussion that’s been generated by you, Stephen, Kurt, Mark Sisson (and others) around starches has been fascinating.

    I feel still (mostly) feel better when my brain must regularly (though not constantly) rely on ketones for fuel (increased concentration and mood stability) but look forward to the day when I can ingest some starch without triggering the “bottomless pit of hunger” because I am able to rest, relax and sleep better with some starch on board.

    Thanks for all of the work you do.


  29. Unlike a land line which is freely available in this white or yellow pages a radio connection is protected just by laws that forbid these being listed publicly.

    However, you often make just a one-time registration. Then only you may discover the particular person’s identity who has been disturbing you for fairly lengthy over the phone.

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