Monthly Archives: March 2011 - Page 2

Seth Roberts and Circadian Therapy

Posted by on March 22, 2011 80 comments

A while back I noted that hypothyroidism is a circadian rhythm disorder and that dietary steps that restore circadian rhythms, like intermittent fasting and daytime eating, should be therapeutic (“Intermittent Fasting as a Therapy for Hypothyroidism,” Dec 1, 2010).

Many other disorders besides hypothyroidism feature disturbed circadian rhythms:

  • Sleeplessness and poor sleep
  • Depression, bipolar disorder, and other psychiatric disorders
  • Dyslipidemia, metabolic syndrome and obesity.
  • Neurodegenerative disorders

Circadian rhythm disruption also suppresses immune function and increases vulnerability to infectious disease.

Restoring or strengthening circadian rhythm may be therapeutic for all of these conditions. Even for healthy people, tactics for enhancing circadian rhythms may improve health.

Which brings us to Seth Roberts.

Seth Cured a Sleep Disorder With Circadian Therapy

Seth is a well-known blogger, a Paleo dieter and psychologist, author of  The Shangri-La Diet, and a great self-experimenter.

Seth recently gave a talk that tells the history of his self-experimentation.

It turns out he suffered from disturbed sleep for many years. He experimented to find cures for 10 years; nothing worked. But then he got a lead.

When a student suggested he eat more fruit, he started eating fruit for breakfast. His sleep got worse! This was exciting to Seth because it was, in 10 years, the first thing he tried that changed his sleep.

He had the idea of trying no breakfast. It turned out that skipping breakfast improved his sleep. One of his slides:

This directly supports our idea that intermittent fasting (confining eating to an 8-hour window each day) should be therapeutic for circadian rhythm disorders such as disturbed sleep and hypothyroidism.

But what’s exciting is that Seth continued his experiments to find other ways to improve his sleep. As a psychologist, he knew that human contact controls when we sleep: people are most awake at the times they have contact with other people, and asleep when isolated.

He knew that watching TV can have effects similar to socializing. So he tried watching Jay Leno one morning. He slept very well the next night.

It turns out that looking at human faces is almost as good as real socializing. Here is Seth’s data relating mood to whether he looked at faces:

Seth also tracked his mood over the course of the day. The response of mood to seeing pictures of human faces clearly followed a circadian (24-hour) rhythm:

Another thing that relates to circadian rhythms is exercise: we normally exercise during the day and rest at night.

For a scholar, the easiest way to exercise is to stand rather than sit (for instance, by working at a standing desk). Seth tried standing 9 hours a day – and it cleared his sleep problem!

Of course, standing is not a very strenuous exercise. Seth found that if he just stood on one leg, the effect was much more intense, and he could fix his sleep problem with only minutes of one-legged standing per day.

He also found that eating more animal food improved his sleep. It’s possible that animal fat may enhance circadian rhythms more than other foods.

Conclusion

I found this fascinating – because it adds more evidence regarding the centrality of circadian rhythms in health – and exciting, because it shows that simple tactics can be therapeutic for circadian rhythm disorders.

In the hypothyroidism post, I suggested the following tactics for improving circadian rhythms:

  • Light entrainment: Get daytime sun exposure, and sleep in a totally darkened room.
  • Daytime feeding: Eat during daylight hours, so that food rhythms and light rhythms are in synch.
  • Intermittent fasting: Concentrate food intake during an 8-hour window during daylight hours, preferably the afternoon. A 16-hour fast leading to lower blood sugar and insulin levels, and the more intense hormonal response to food that results from concentration of daily calories into a short 8-hour time window, will accentuate the diurnal rhythm.
  • Adequate carb intake: Eat at least 400 “safe starch” carbohydrate calories daily during the afternoon feeding window. Relative to a very low-carb diet, this will increase daytime insulin release and, by increasing insulin sensitivity, may reduce fasting insulin levels. It will thus enhance diurnal insulin rhythm.

To these, we can add several more based on Seth’s findings:

  • Looking at human faces: If you work at a computer, keep a window up that cycles among photos of faces, or shows a video of a talk show; keep photos of your family near your screen.
  • Standing: Work at a standing desk or, failing that, get in the habit of standing on one leg rather than two.
  • Animal fat: Eat a diet high in animal fats.

These tactics cured Seth’s sleep disorder. Might these tactics also cure or greatly improve other circadian rhythm disorders – including hypothyroidism and psychiatric disorders like depression and bipolar disorder? Could looking at human faces help the obese lose weight and improve their lipid profiles?

I don’t know but I’d certainly give these techniques a try before pharmaceutical drugs. I believe these techniques deserve clinical testing as therapies for all diseases associated with disrupted circadian rhythms. I believe that they may be just as beneficial for the healthy: by improving immune function, they may delay aging and extend lifespan.

A few weeks ago, when I posted a video of Don Rumsfeld defending the use of a standing desk (the same video was later linked by John Durant and Mark Sisson), I brashly stated, “There are few single life adjustments more likely to improve your health than working at a standing desk.”

Perhaps that statement wasn’t as exaggerated as it may have seemed!

Seth’s Talk

Steak Diane (Ribeye with Cream Sauce)

Posted by on March 20, 2011 22 comments

Ribeye steak is a staple in our house; we eat it almost every week. Its low omega-6 content makes beef, along with fish like salmon, our favorite meat. Ribeye is a fatty cut, which fits Perfect Health Diet macronutrient ratios.

Given how important it is in our diets, you might think we’d have a lot of fancy recipes; but simple grilled or pan-fried steak is highly satisfying, and also very quick. We’ll usually have a simple seasoned grilled steak, or pan-fried steak with a simple sauce, along with vegetables and a starch on the side.

Although our steaks are usually simple, I think it’s worth a post to show what we do. We would be curious to hear what sauces our readers like on steak.

Pan-Fried Steak in Cream Sauce

This is better known as Steak Diane, after Diana the Roman goddess of the hunt; it is a simple recipe such as a hunter might use.

Here’s what we typically buy:

These are regular grain-fed, not grass-fed, steaks; grain-fed is cheaper and fattier, both of which we like, and the omega-6 content is reasonably low even in grain-fed beef.

We eat toward the lower half of our recommended protein range, which translates to between 0.5 lb and 1 lb (0.4 to 0.8 kg) meat per day. So this $20 package represents a 2 day supply of meat for 2 people. At $5 per person per day, it’s quite affordable. Certainly cheaper than restaurant meals!

Here are a few ingredients for the sauce:

Butter, cream, lemon for juice, rosemary, garlic, and bay leaves. The bay leaves are rather old and brown, but might as well use them up.

We start with some coconut oil, rosemary, garlic, and bay leaves, and two steaks seasoned with salt and pepper.

We brown them about 1 1/2 minutes per side at medium to high heat:

At that point we pull them out, carve them into smaller sizes, and return them along with the butter to the pan:

After another 2 minutes per side, the steaks are ready to remove from the pan. We then use the pan residue to make a sauce.

Normally we might add mushrooms, onions, or other vegetables to the sauce, but today we were pressed for time and just added cream and some lemon juice to the pan. It looked like this at first:

Stir it at low heat and remove as soon as ingredients are mixed; the sauce looks like this:

Note: Don’t eat the bay leaves! They flavor the sauce, but the leaves contain toxins. We removed the bay leaves before adding cream to the sauce.

We always have some rice around – we run the rice cooker once every 3 days or so – and some seasoned seaweed, kimchi, and baby carrots for vegetables when we need them. So if we’re pressed for time and don’t feel like cooking plant foods, dinner will look like this:

(Kimchi and seasoned seaweed not shown. We also put the sauce over the rice.)

Table-grilled steak

If we’re even more pressed for time and would like to relax in our living room while cooking – maybe to watch a movie or television show – then we’ll grill our steak at the table.

Cooking at the table is a tradition in Asia; many restaurants have grills built into the dining tables so that diners can barbecue their food.

The easiest way to do this is to buy an electric table grill. We got ours for $20 at an Asian supermarket. Amazon has some fancier models:

Here’s the steak cooking:

On our table grill, the heat is lower near the edges than in the center. So we usually need to pull the steak when the center part is cooked, cut off the edges, and return the undercooked edges to the grill:

Here’s the steak fresh off the grill:

Add whatever plant foods you like! We’ll typically do bell peppers as here, onions, portobello mushrooms, or asparagus.

It’s hard for a meal to get easier to prepare than this. The table grill is easy to clean also – both the grilling surface and a pan to catch drippings pull out and clean easily.

Steak Diane with Gordon Ramsey

Here is Gordon Ramsey cooking essentially the same meal:

Around the Web; and Another Reason to Cook at Home

Posted by on March 19, 2011 11 comments

Here are items that caught my eye this week:

[1] Iodine watch! Japan fallout tracker: So you got potassium iodide somehow, and want to know whether to take it. Here’s an animated gif from the Central Institute for Meteorology and Geodynamics (ZAMG) in Austria that shows the radiation plume from the Japanese reactors. Luckily, the prevailing westerly winds have to date been blowing the radioactivity out to sea. Unluckily, the forecast is for winds to calm this weekend, which may direct the plume toward Tokyo by Sunday.


Ausbreitung der Wolke von Fukushima/permanente Freisetzung/Jod-131

(via Zero Hedge)

The danger is not negligible for the Japanese. Over 4,200 tons of radioactive material are present at the Fukushima site – 24 times the amount present at Chernobyl – although in general the material is less radioactive (due to having already decayed significantly) than the Chernobyl materials. I hope that the world’s potassium iodide supplies are being directed to Japan at the moment. It would be a shame for them to be short-handed.

[2] Panic! Salt shortage in China: The Chinese may be over-reacting to the reactor story. Here they are mobbing a salt vendor in search of iodized salt:

A technician in my wife’s lab reports that her mother-in-law in China bought 20 bags of iodized salt – a lifetime supply – last week, just to be “safe.”

Let’s hope no one dies of salt toxicity trying to protect themselves from radioactivity!

Panic buying is not confined to China. Americans are paying exorbitant prices for iodine, even though the radiation danger here is almost non-existent. The price of the Iodoral tablets we recommend has tripled on Amazon; FDA-approved iodine supplements have risen in price almost 20-fold.

[3] Animal photo: Bad news calls for a hug:

[4] Used copies for sale?: If anyone wants to sell their copy of our book, Zoë would like to hear from you!

[5] Mmmmmmm!: If Sunday is too far away and you need a food post, Guy Giard has your fix. To work up an appetite, click on the cute couple:

[6] How was your meat glue?: As if we didn’t already have enough reasons to cook at home, here’s a new one. Restaurants not only use bad oils and MSG, some of them save money by buying recycled meat scraps, re-assembled into a facsimile of fresh meat through the use of “meat glue” – enzymatic treatment with tissue transglutaminase.

Tissue transglutaminase will be familiar to readers of our book as a primary player in gluten autoimmunity. It is expressed whenever wounds need repair, and helps cross-link proteins. This allows it to knit meat pieces together so they appear like natural flesh.

The trouble is that bacteria collect on the surface of meat. With a whole piece of meat, it is normally sufficient to cook the surface; rare meat is safe, since cooking kills the surface bacteria and the uncooked interior was antiseptic.

But when many small scraps are knitted together this way, the bacteria are retained in the interior of the meat. If the whole “steak” is not thoroughly cooked, bacteria will not be killed and the meat will be infected and unsafe.

Here is a video from Australian TV. Can you tell the real meat from the glued scraps?

[7] New foods to try: Melissa McEwen recommends fermented rice foods: “Indian Idli, which Stephan has blogged about … [is] SO DELICIOUS…. Filipino Puto [is] SO chewy and delicious with butter!… There is also some evidence that fermented rice improves cholesterol markers and reduces fatigue in animals.”

[8] Brain-Gut connections: It seems that trauma to the brain induces a leaky gut within 6 hours. I would never have guessed this as a cause of leaky gut. (Via Chris Kresser)

[9] Good news for Short People: Being small might be an advantage.

[10] True: “No lesson seems to be so deeply inculcated by experience of life as that you should never trust experts. If you believe doctors, nothing is wholesome; if you believe theologians, nothing is innocent; if you believe soldiers, nothing is safe.” – Lord Salisbury

[11] Top posts: Chris Masterjohn has a superb post, “Genes, LDL-Cholesterol Levels, and the Central Role of LDL Receptor Activity In Heart Disease”. It is too rich to summarize, but the best post I read this week. Also, Chris Kresser is nearing the end of his “9 Steps to Perfect Health” series (I’m jealous! We only had four steps.) This week he advises “Get More Sleep”.

[12] Almost the Top Post: Maybe I should buy some crickets. It seems hunting crickets is a very effective way to relieve stress – at least for cats. Mark Sisson’s friend’s cat recovered from disease by hunting crickets. What do you think? Will it work for people too?

[13] Lower Manhattan from Brooklyn Bridge Park:

(via Craig Newmark)

[14] Not the weekly video: Are earthquakes predicted by high tides, fish kills, whale beachings, homing pigeons going astray, and clockwise rotation of earthquakes around linked faults?

If so, there might be shaking on the west coast of North America this week:

[15] Weekly video: After all this disaster talk we can use a little fun. Here’s Dean Martin and Goldie Hawn, flirtatious and funny, from Rowan & Martin’s Laugh-In:

Iodine, the Thyroid, and Radiation Protection

Posted by on March 17, 2011 86 comments

We have friends in Japan, living both north and south of the damaged reactors, and Shou-Ching asked me to do a post about how to protect against radiation.

The Concern

The radioactive substances released by the Chernobyl nuclear power plant meltdown are represented in this chart:

(Source. If you’re wondering what the other radioactive elements are, or why radioactive iodine is a byproduct of uranium fission, a possible place to start is Wikipedia, “Fission products by element” ).

Note first of all that the chart presents percentages of radioactive substances, not amounts. The amounts are highest on the first day and then decline rapidly. The great danger comes in the first few days.

During these dangerous first days, iodine-131 is, along with tellurium-132 and its decay product iodine-132, the dominant source of radioactivity. These radioactive iodine species account for over 50% of the radiation.

Not only its abundance, but also its effectiveness at causing biological damage make iodine far and away the greatest danger. Iodine radiation is highly effective at causing cellular damage:

Due to its mode of beta decay, iodine-131 is notable for causing mutation and death in cells which it penetrates, and other cells up to several millimeters away. [Source: Wikipedia, Iodine-131]

Worse, iodine is an important biological molecule that gets concentrated in the thyroid. So the dose of radiation becomes very high in the thyroid, and this leads to DNA damage producing a high risk for thyroid cancer.

Thyroid cancer is “the only unequivocal radiological effect of the Chernobyl accident on human health.” [1] Since Chernobyl released a great deal more radiation than the Japanese reactor meltdowns are likely to do, it’s likely that this will be the case in Japan also.

The rate of thyroid cancer after Chernobyl was higher the younger the age at time of exposure. Children and infants are at greatest risk:

It is now well documented that children and adolescents exposed to radioiodines from Chernobyl fallout have a sizeable dose-related increase in thyroid cancer, with the risk greatest in those youngest at exposure and with a suggestion that deficiency in stable iodine may increase the risk. [2]

The last point is crucial – iodine deficiency increases the risk.

Iodine deficiency and radiation risk

In iodine deficiency, the thyroid gland has difficulty generating enough thyroid hormone. T4 thyroid hormone, manufactured in the thyroid and so named because it has 4 iodine atoms, is 65.4% iodine by weight, so iodine is the key ingredient in thyroid hormone.

To compensate for an iodine deficiency, the body does two things:

  • The thyroid gland grows, so that it can more aggressively scan the blood for iodine. An enlarged thyroid is called a goiter.
  • The pituitary gland issues thyroid stimulating hormone (TSH), which induces the thyroid to aggressively scavenge iodine from the blood and turn it into thyroid hormone.

So in iodine deficiency the thyroid is aggressively scavenging all available iodine. This means that when a large dose of iodine-131 or iodine-132 arrives during radiation fallout, these radioactive iodine atoms are quickly picked up by the thyroid. There, they release their radiation and damage the thyroid.

On the other hand, in thyroid replete persons, the thyroid has all the iodine it needs and takes up little iodine from the blood. In this case, iodine that enters the body is distributed throughout the body, or excreted. Doses in any single cell are much lower. The danger to the thyroid is not much greater than that to other organs – which, the Chernobyl experience tells us, is not detectable to epidemiology. (There is even a theory that low-level radiation may be beneficial through hormesis.)

How can the thyroid be made replete with iodine?

The best way, which we recommend in our book, is to supplement with iodine and gradually build up the dose over a four to six month period. Start below 1 mg/day, take that for a month, then double the dose. After a month, double the dose again. Continue doubling until you reach your desired maintenance dose; we recommend at least 3 mg/day (a quarter Iodoral tablet), with 12.5 mg/day a reasonable dose. Some people taking as much as 50 mg/day.

At 12.5 mg/day, it can take a year or more to become replete with iodine in all tissues and to fully drive out other halogens, such as bromine, from the body. This has great benefits for immune function. So, it is best to get started!

Risks of high-dose iodine supplementation

If a person’s thyroid gland is adapted for iodine scarcity and the person takes a large dose of (non-radioactive) iodine, the likely course of events is:

1.      Hyperthyroidism. The thyroid, aggressively scavenging for iodine to repair a deficiency of thyroid hormone, scoops up all the iodine and makes a large amount of thyroid hormone. The person develops symptoms of hyperthyroidism (too much thyroid hormone): anxiety, intolerance of heat, muscle aches, hyperactivity, irritability, hypoglycemia, elevated body temperature, palpitations, hair loss, difficulty sleeping.

2.      Wolff-Chaikoff effect. As thyroid hormone levels become too high, the body induces mechanisms for suppressing thyroid hormone production. Simply reducing TSH output is not effective to suppress thyroid hormone production if a very large iodine influx is received. Fortunately there is another mechanism for suppressing thyroid hormone formation, mediated by iodine itself: the formation of iodine-rich proteins (iodopeptides) in the thyroid that inhibt synthesis of the thyroid peroxidase (TPO) enzyme. Normally, this mechanism operates for a few days and wears off, restoring normal thyroid function. [3]

3.      Reactive hypothyroidism? Usually, everything will normally return to normal after a few days. But sometimes in previously iodine-deficient adults and more commonly in newborns and fetuses and some diseased persons, after very high doses of iodine the Wolff-Chaikoff effect can persist. In this case the early hyperthyroidism is followed by a period of hypothyroidism (too little thyroid hormone). This “hypothyroidism is transient and thyroid function returns to normal in 2 to 3 weeks after iodide withdrawal, but transient T4 replacement therapy may be required in some patients.” [3]

4.      Risk for lasting hypothyroidism. People who develop a reactive hypothyroidism following a large dose of iodine are at high risk for later development of persistent hypothyroidism. [3]

So most people will experience transient hyperthyroid symptoms for a few days and then do fine. Some will develop a reactive hypothyroidism lasting a few weeks and then be OK, save for an elevated risk of hypothyroidism later which may or may not be due to the reactive episode.

Advice of the authorities to fallout victims

The advice from public health authorities is a compromise between the protective effects of high-dose iodine and the risk of messing up the thyroid.

A US Center for Disease Control (CDC) fact sheet explains the recommendations. A single large dose of iodine offers protection for about 24 hours. Recommended intakes are:

  • Adults should take 130 mg/day while exposure persists.
  • Children older than 3 and smaller than adults should take 65 mg/day while exposure persists.
  • Infants and toddlers aged 1 month to 3 years should take 32 mg/day.
  • Newborns should take 16 mg/day.

Our advice

The CDC dosage advice strikes us as very reasonable.

If you are not currently exposed to fallout, but think you may be exposed in the near future, you should consider beginning with small doses of iodine now – say, 3 mg/day. If that does not produce any symptoms, then try 6 mg/day; if it does, back off to half that dose. This will begin the adaptation process for your thyroid gland and help minimize hyperthyroid or hypothyroid reactions if you do have to take high doses.

Also, obtain your iodine tablets in advance. If fallout does occur, it may be hard to find iodine pills. NukePills.com says they are out of stock and have a large order backlog. I saw a story the other day that a 14-dose packet of potassium iodide was being sold at one site for $200, up from the normal $10 list price.

We recommend Iodoral 12.5 mg tablets. This is a good size for supplemental use; to reduce it to a 3 mg dose, cut the tablet in quarters with a razor blade. If fallout arrives, you can use ten Iodoral tablets to get a 125 mg adult dose.

For doses below 3 mg, smaller iodine tablets or liquid iodine solutions may be best; you can dilute liquid solutions to your desired dose. Some brands were recommended by readers in comments on our Supplement Recommendations page.

Conclusion

Outside of Japan, the risk is minimal, and even in Japan those who are replete with iodine are unlikely to develop thyroid cancer from exposure. After Chernobyl, thyroid cancer rates were high in Russia, the Ukraine, and Belarus which did not distribute iodine, but low in Poland which did. Fortunately, Japan has one of the highest iodine intakes in the world thanks to its high seaweed consumption. With that preparation plus proactive distribution of iodine tablets, we can expect and hope that the health effects of the reactor meltdowns will be minimal.

References

[1] Thomas GA et al. Integrating Research on Thyroid Cancer after Chernobyl-The Chernobyl Tissue Bank. Clin Oncol (R Coll Radiol). 2011 Feb 22. [Epub ahead of print] http://pmid.us/21345659.

[2] Cardis E, Hatch M. The Chernobyl Accident-An Epidemiological Perspective. Clin Oncol (R Coll Radiol). 2011 Mar 9. [Epub ahead of print] http://pmid.us/21396807.

[3] Markou K et al. Iodine-Induced hypothyroidism. Thyroid. 2001 May;11(5):501-10. http://pmid.us/11396709.