Monthly Archives: May 2011 - Page 3

Around the Web; Morgellons Edition

Posted by on May 14, 2011 32 comments

Here’s what caught my eye this week:

[1] Interesting posts this week: Stephan Guyenet’s discussion with Chris Kresser is sure to be fascinating, because the material left on the cutting room floor is great. I especially liked Stephan’s observations about insulin’s contributions to weight loss, via promoting satiety and leptin sensitivity.

Chris Masterjohn refutes an old canard: The cannibals of New Guinea preferred fishermen, not missionaries. Of course – fishermen are more nutritious, they have more iodine.

Apropos this week’s post (Can Endurance Exercise Promote Cancer?, May 11, 2011), Keith Norris of Theory to Practice discusses the relation between fitness and health:


Personally, I’ve never gotten to the right of the part of the curve labeled “Health” and “Performance,” and spent too much time in the area off the chart called “Unhealth” and “Non-performance.”

Via Obesity Panacea’s Travis Saunders, exercise induces weight loss in controlled laboratory conditions but not in real life. Scientists discover that Vancouver bedbugs are carrying antibiotic-resistant staph (MRSA). Chronic acetaminophen (Tylenol) use doubles the risk of blood cancers. Aspirin is better.

Via Dr Cobb at Z-Health, a study showing that walking barefoot decreases stress on the knees and hips of people with osteoarthritis. Charles Poliquin defends his high-dose fish oil recommendation with a study showing that 7 people were able to take 60 g/day fish oil for 12 weeks without “serious adverse events.”

Finally, Richard Nikoley has some mouth-watering food photos.

[2] Post-Mother’s Day music:

[3] Morgellons, a medical mystery: Via The Guardian, a mysterious complaint:

Morgellons was named in 2001 by an American called Mary Leitao, whose son complained of sores around his mouth and the sensation of “bugs”. Examining him with a toy microscope, Leitao found him to be covered in unexplained red, blue, black and white fibres. Since then, workers at her Morgellons Research Foundation say they have been contacted by more than 12,000 affected families….

Optical image of what sufferers are adamant are morgellons fibres in skin samples – are they made up of alien ­matter, or are ­everyday materials the more likely explanation? Photograph: Vitaly Citovsky/Suny at Stony Brook

Back in London, I find a 2008 paper on morgellons in the journal Dermatologic Therapy that describes patients picking “at their skin continuously in order to ‘extract’ an organism”; “obsessive cleaning rituals, showering often” and individuals going “to many physicians, such as infectious disease specialists and dermatologists” – all behaviours “consistent with DOP”. (For treatment, the authors recommend prescribing a benign antiparasitic ointment to build trust, and supplementing it with an antipsychotic.)

These dermatologists don’t know much, but they know an antipsychotic drug is the treatment.

Fortunately there is an excellent doctor looking into the matter:

I contact Dr Anne Louise Oaklander, associate professor at Harvard Medical School and perhaps the only neurologist in the world to specialise in itch. I email her describing morgellons, pointing out it’s probably some form of DOP. But when we speak, she knows all about morgellons already. “In my experience, morgellons patients are doing the best they can to make sense of symptoms that are real. They’re suffering from a chronic itch disorder that’s undiagnosed. They have been maltreated by the medical establishment. And you are welcome to quote me on that,” she adds….

“That they have insects on them is a very reasonable conclusion because, to them, it feels no different from how it would if there were insects on them. To your brain, it’s exactly the same. So you need to look at what’s going on with their nerves. Unfortunately, what can happen is a dermatologist fails to find an explanation and jumps to a psychiatric one.”

[4] Let’s ride:

Via Yves Smith

This picture reminds me of a story. I once was on a long airplane flight seated next to two girls who demanded piggy-back rides around the cabin. They asked me to guess their ages. After I had guessed every age from 3 to 13, I gave up. Can you guess how old they were?

Select for the answer: They were 5½ and 7½!

[5] Does it cure being a lawyer?: A “therapy dog” is available for checkout at the Yale Law School library. But he can’t be removed from the library, because he’s a rufference work. (Via Tom Smith.)

[6] They’re born and they’re off to college, just like that: Via John Durant, a robin raises her chicks:

Robins: 4 Eggs, 4 Weeks from Fred Margulies on Vimeo.

[7] The raccoon who will live forever in our memories: Stabby has been immortalized:

It’s only the beginning, I believe. That raccoon has great things ahead of him!

[8] Those were the days: The medicines weren’t that great, but the advertising posters were cool. Via The Scientist, a slideshow of mostly 19th century medicinal posters:

[9] The old mannequin head drop prank: This one always works.

via Amy Alkon.

[10] Shou-Ching’s photo-art:

© 2011 Shou-Ching Jaminet.

[11] Video of the week: Polar photographer Paul Nicklens shares some remarkable photographs. Don’t miss the part where the friendly leopard seal tries to feed him penguins:

Can Endurance Exercise Promote Cancer?

Posted by on May 11, 2011 50 comments

I got into a bit of trouble in the comments a few weeks back when I joked that Grete Waitz may have died from marathoning. Steve replied:

Paul, you said “… marathoning (from which Grete Waitz just died at 57)”

Gee. The news said cancer. How confident are you that she died “from” running marathons?

Of course, not confident at all. Maybe if she’d been a sprinter she would have died at 54. Maybe if Lance Armstrong had been a couch potato he would still have had testicular cancer metastasized to his brain and lung at age 25.

A few days ago I got an email. Two highly fit endurance athletes, both of whom have always tended to their health and been careful to eat “healthy” (i.e. vegetable and whole grain rich, meat and fat poor) diets, have contracted cancers in the prime of life and been given less than a year to live. My correspondent asked, “Why?”

Let’s look into this. Is it possible that endurance exercise, especially if combined with a high-carb diet, may promote cancer?

Oxidative Damage to DNA and Cancer

Human DNA is constantly being damaged and repaired. It’s been estimated that over the course of a cell cycle – that is, from the time a cell is formed to the time it divides into two daughter cells – a human cell develops 5,000 single-stranded DNA breaks due to oxidative damage from reactive oxygen species (ROS). The vast majority are repaired by the body’s DNA repair machinery. [1]

However, in typical human cells 0.1% or 5 are not successfully repaired; instead a corresponding break is created in the complementary DNA strand, resulting in a double-strand break. In people with Bloom syndrome, an inherited condition which creates a strong predisposition to cancer, fully 1% or 50 are not successfully repaired. [1]

The double-strand break leads to a re-arrangement or “translocation” of parts of the chromosome. Usually, this does not break the coding region for a protein, but it does break non-coding regions resulting in changes to gene expression.

These sorts of genetic changes are observed both in cancer and in aging. [1] In short, oxidative damage to DNA is considered a risk factor for cancer development.

Oxidative Damage to DNA Has Been Specifically Linked to Endurance Exercise

Diets and activities that increase oxidative stress – for instance, diets deficient in antioxidant minerals – can therefore increase cancer risk. And diets and activities that minimize oxidative stress can minimize cancer risk and facilitate recovery.

Endurance exercise generates oxidative stress. Marathon running “caused a large increase in the tissue content of oxidized glutathione (189%) at the expense of reduced glutathione (-18%).” [2]

Moreover, endurance exercise damages DNA:

Both a systemic inflammatory response as well as DNA damage has been observed following exhaustive endurance exercise….

Extremely demanding endurance exercise has been shown to induce both a systemic inflammatory response [15, 42, 53, 71] as well as DNA damage [21, 36, 58, 62, 80]….

Exercise-induced DNA damage in peripheral blood cells appear to be mainly a consequence of an increased production of reactive oxygen and nitrogen species (RONS) during and after vigorous aerobic exercise [58]. Besides oxidative stress, other factors such as metabolic, hormonal and thermal stress in addition to the ultra-structural damage of muscle tissue are characteristic responses to prolonged strenuous exercise, that can lead to the release of cytokines, acute phase proteins and to the activation or inhibition of certain lines of the cellular immune system [15, 29]. [3]

There seems to be a big difference between moderate exercise and exercise to exhaustion. Moderate exercise actually protects DNA by upregulating DNA repair:

Sato et al. showed that acute mild exercise as well as chronic moderate training does not result in DNA damage, but rather leads to an elevation in the sanitization system of DNA damage [66]. [3]

However, endurance exercise leads to increased DNA damage:

Increased levels of DNA strand breaks were observed after exhaustive treadmill running in subjects of different training status [22, 45]….

In conclusion, there is growing evidence that strenuous exercise can lead to DNA damage that with few exceptions [36] is predominantly observed not before 24 h after the resolution of exercise [21, 44, 45, 80]. [3]

In addition, strenuous endurance exercise induces hormonal and other changes which might promote cancer. An Ironman triathlon has significant effects on hormones and inflammatory markers, some of which persist for more than 19 days post-race:

Briefly, as described in details elsewhere [42], there were significant (P<0.001) increases in total leukocyte counts, MPO, PMN elastase, cortisol, CK activity, myoglobin, IL-6, IL-10 and hs-CRP, whereas testosterone significantly (P<0.001) decreased compared to pre-race. Except for cortisol, which decreased below pre-race values (P<0.001), these alterations persisted 1 d post-race (P<0.001, P<0.01 for IL-10). Five days post-race CK activity, myoglobin, IL-6 and hs-CRP had decreased, but were still significantly (P<0.001) elevated. Nineteen days post-race most parameters had returned to pre-race values, with the exception of MPO and PMN elastase, which had both significantly (P<0.001) decreased below pre-race concentrations, and myoglobin and hs-CRP, which were slightly, but significantly higher than pre-race [42]. [3]

In the opinion of the authors of this review, the biggest problem is production of reactive oxygen and nitrogen species (RONS) by damaged immune cells:

The most conclusive picture that emerges from the available data is that oxidative stress seems to be the main link between exercise-induced inflammation and DNA damage…. DNA damage in peripheral immuno-competent cells, indeed, most likely resulted from an increased generation of RONS due to initial systemic inflammatory responses or the delayed inflammatory processes in response to muscle damage (Fig. 1). [3]

What About High-Carb Diets?

Do high-carb diets contribute?

During strenuous exercise mitochondria produce oxidation products:

The mitochondrial electron transport system can trigger the formation of superoxide leading to increased production of H2O2 by superoxide dismutase [49], [50]. [4]

In a normal person at rest, about 1-2% of the oxygen utilized by mitochondria ends up in superoxide. [4]

Before we go further let’s take a brief detour into mitochondrial chemistry: specifically, something called the electron transport chain.

Here’s a stylized view:

Source: Wikipedia.

The main point for our purposes is that there are two points of entry into the chain, one that goes through complex I and one that bypasses it.

Glucose metabolism favors entry via complex I, while fatty acid metabolism is relatively more favorable to entry via complex II. Quantitatively, glucose metabolism produces 5 NADH molecules (entering at complex I) for every one succinate molecule (entering at complex II), while fatty acid metabolism produces only 2 NADH for every one succinate.

High-carb dieting tends to habituate the body to metabolism of glucose. Therefore, it increases utilization of complex I.

This is significant because complex I is vulnerable to production of excess oxidative stress under some circumstances.

In principle, every mitochondrial complex has the potential to operate cleanly with minimal production of superoxide. However, if mitochondrial function is in any way impaired, so that operation of a complex is inhibited, then ROS production can rise substantially.

If for some reason electrons cannot flow properly through the electron transport chain, then they leave as superoxide:

One factor which may sensitise cells to increased DNA damage is impaired mitochondrial function [74]…. Reduced electron flow through the mitochondrial respiratory chain, particularly through the inhibition of complex I or complex III, favours the enhanced production of superoxide and H2O2 [75]. Together, with the age-dependent increase in oxidative stress and decline in NAD+ and ATP content, we found a tendency to the reduction in the activity of the respiratory complexes with age in all organs. Sipos et al. (2003) showed that mitochondrial formation of H2O2 due to complex I inhibition is more clinically relevant than ROS production due to inhibition of complex III and IV in situ [76]. [4]

What exactly did Sipos et al. find?  They state:

ROS formation was not detected until complex III was inhibited by up to 71 +/- 4%, above that threshold inhibition, decrease in aconitase activity indicated an enhanced ROS generation. Similarly, threshold inhibition of complex IV caused an accelerated ROS production. By contrast, inactivation of complex I to a small extent (16 +/- 2%) resulted in a significant increase in ROS formation, and no clear threshold inhibition could be determined. [5]

Basically, superoxide can be generated in complexes I, III, and IV. However, in complexes III and IV, there is a high threshold of inhibition of electron transport before any superoxide is produced. In complex I, there is no threshold:  even very slight inhibition will generate ROS. This means that during practical living, the great majority of excess ROS is produced from complex I.

This means that high-carb dieting, which increases utilization of complex I, will tend to generate oxidative stress if there is any inhibition of complex I.

But in endurance exercise, there is inhibition of complex I. To name just one pathway, exercise increases levels of the hormone DHEA, and DHEA inhibits complex I. [6]

It looks like high-carb diets and endurance exercise may be a bad combination.

Are Whole Grains Especially Bad?

There may be specific problems with grain toxins. For instance, wheat germ agglutinin, a wheat toxin that is very effective at distributing itself through the body through transcytosis, is able to damage mitochondria:

WGA induced a loss of transmembrane potential, disruption of the inner mitochondria membrane, and release of cytochrome c and caspase-9 activation after 30 min of cell interaction. [7]

At high doses in test tubes this can lead to cell death. It’s conceivable that at physiological levels WGA damage to mitochondria might mildly inhibit complex I and increase oxidative stress.

Of course, any deficiency in antioxidant minerals zinc and copper, which dismutate superoxide to hydrogen peroxide which is then disposed of by glutathione peroxidase (a selenium containing enzyme), would increase oxidative stress. Wheat contains phytic acid which chelates minerals and reliance on wheat as a calorie source may impair antioxidant status.

Conclusion

I don’t want to exaggerate the risks of endurance sports. With the exception of melanoma [8], there isn’t a clear increase in cancer incidence among marathon runners. And if this post seemed a bit tortuous, it’s because there’s no simple “smoking gun” pathway connecting endurance exercise to cancer.

On the other hand, endurance exercise is probably not as healthy, in terms of cancer risk, as shorter-duration activities. Also, the risk may rise substantially on high-carb or wheat-based diets. There are at least a few plausible mechanisms, not all of which I’ve discussed here, that might connect endurance exercise on grain-based high-carb low-fat diets to cancer.

References

[1] Vilenchik MM, Knudson AG. Endogenous DNA double-strand breaks: production, fidelity of repair, and induction of cancer. Proc Natl Acad Sci U S A. 2003 Oct 28;100(22):12871-6. http://pmid.us/14566050.

[2] Cooper MB et al. The effect of marathon running on carnitine metabolism and on some aspects of muscle mitochondrial activities and antioxidant mechanisms. J Sports Sci. 1986 Autumn;4(2):79-87. http://pmid.us/3586108.

[3] Neubauer O et al. Exercise-induced DNA damage: is there a relationship with inflammatory responses? Exerc Immunol Rev. 2008;14:51-72. http://pmid.us/19203084.

[4] Braidy N et al. Age related changes in NAD+ metabolism oxidative stress and sirt1 activity in wistar rats. PLoS One. 2011 Apr 26;6(4):e19194. http://pmid.us/21541336.

[5] Sipos I et al. Quantitative relationship between inhibition of respiratory complexes and formation of reactive oxygen species in isolated nerve terminals. J Neurochem. 2003 Jan;84(1):112-8. http://pmid.us/12485407.

[6] Safiulina D et al. Dehydroepiandrosterone inhibits complex I of the mitochondrial respiratory chain and is neurotoxic in vitro and in vivo at high concentrations. Toxicol Sci. 2006 Oct;93(2):348-56. http://pmid.us/16849397

[7] Gastman B et al. A novel apoptotic pathway as defined by lectin cellular initiation. Biochem Biophys Res Commun. 2004 Mar 26;316(1):263-71. http://pmid.us/15003540.

[8] Ambros-Rudolph CM et al. Malignant melanoma in marathon runners. Arch Dermatol. 2006 Nov;142(11):1471-4. http://pmid.us/17116838.

Happy Mother’s Day! with Hot Chocolate

Posted by on May 8, 2011 25 comments

Our best wishes to all Moms!

We thought we’d post something kids and moms can enjoy together: hot chocolate.

Hot Chocolate

We recommend some combination of whole milk or heavy cream, dark chocolate, and coconut milk or coconut oil.

We like ours thick so we used cream and coconut oil. (Shou-Ching suggests mixing some coffee with the cream — for Mom only! (Paul suggests some Irish whiskey.)) We used 72% chocolate, which is sweet but not too sweet.

We mixed about 100 g chocolate with a heaping tablespoon (~2 tbsp) coconut oil and 1 cup cream. Melt the chocolate with the oil in a sauce pan:

Then add the cream or milk and stir until well mixed:

Whipped Cream

It wouldn’t be hot chocolate without whipped cream on top. We use 1 cup heavy whipping cream and 1 tbsp rice syrup as a sweetener.

We do the preparation in the same plastic container we’ll use to store the extra whipped cream – less cleanup that way:

Whip the cream, then add the rice syrup and whip some more:

Serve

Transfer everything to a mug and top with cinnamon or nutmeg:

Happy Mother’s Day everyone!

Around the Web; Say Hey Kid edition

Posted by on May 7, 2011 17 comments

Here’s what caught my eye this week:

[1] First, thank you to Mark Sisson: Our thanks to Mark Sisson and Mark’s Daily Apple for listing us among his “18 Underrated Blogs You Should Be Reading”. We’re in excellent company because all 18 are great blogs. Many of the blogs are fairly new, which demonstrates how rapidly the Paleosphere is growing. Mark is in many ways the leader of the Paleo movement (deservedly so), so we’re honored and proud to be recommended by him.

[2] For aural amusement: I love the way Dinah Washington sings this song.

[3] Interesting posts this week: Speaking of Mark, he somehow produces high-quality interesting posts every day. This week I was intrigued to learn that Australian aborigines were engaging in eel farming on a massive scale as early as 6,000 BC.

Melissa McEwen commented on “Venus-gate”.  Also in Paleolithic commentary, anthropologist Julien Riel-Salvatore gives an update on the finding that Neanderthals cooked starches by boiling in water or moist baking. Quick summary: at Shanidar, Iraq, they cooked date palms, wild barley and legumes; at Spy, Belgium, they cooked water lily corms, sorghum, and five other starchy plant species.

Chris Masterjohn had a fascinating post: “When Fat Burns In the Flame of Lean Muscle Mass — Better Put That Butter Either on Steak or Potatoes”. I left some thoughts in a comment there.

In his post welcoming Mark’s Daily Apple readers, Chris mentioned us among his top referrers. We’re delighted to have passed readers along, but disappointed that we rate so highly – it means others aren’t linking to him enough!

Emily Deans writes on who’s vulnerable to stress and why.

The Scientist tells us that oxidative stress in birds produces timidity as well as shortened lifespan.

Greg Laden of Science Blogs addresses the claim that Paleolithic peoples didn’t live long. In fact, it appears that life expectancy of girls was well into the 50s; as in all premodern societies, the greatest mortality was at childbirth and infancy.

The New York Times joins Ray Peat, Matt Stone, and others in discussing possible benefits of fructose at low doses. It turns out that after intense exercise or fasting has depleted glycogen, glycogen is replenished most rapidly by a mix of 2 parts glucose to 1 part fructose. Precisely the ratio in bananas! Perhaps bananas are the best breakfast.

The New York Times also reported on a study which found the lowest mortality with intake of more than 6 grams of sodium per day. That’s about 2 teaspoons of salt.

In yet a third New York Times report, we learn that removal of the tonsils causes obesity. Of course, the tonsils have an immune function, obesity is a disease, and pathogens cause disease. But that’s not the explanation doctors are proposing:

One of several theories is that enlarged tonsils cause difficulty swallowing, prompting a child to eat less. Once the tonsils are removed, appetite returns.

For lovers of baked goods, Chef Rachel Albert, the Healthy Cooking Coach, has a 99% Perfect Health Diet compliant (save for a bit of legume-derived xanthum or guar gum) recipe for Rosemary-Garlic Popovers.

[4] That plush toy looks real:

[5] Venus-gate revisited: Those odd-shaped Paleolithic figurines? Maybe they were a result of the Gravettian liposuction industry.

Gina Kolata (“With Liposuction, the Belly Finds What the Thighs Lose”) reports that liposuction doesn’t produce lasting weight loss. When liposuction is used to remove fat from one part of the body, the fat comes back elsewhere:

It took a year, but it all returned. But it did not reappear in the women’s thighs. Instead, Dr. Robert H. Eckel said, “it was redistributed upstairs,” mostly in the upper abdomen, but also around the shoulders and triceps of the arms.

[6] How to lose weight fast: Stephan Guyenet continues his must-read series on links between the brain’s reward system and obesity with a post on “How to Make a Rat Obese” and “How to Make an Obese Human Lean”. Secret to the latter? Stock your refrigerator like this:

I wonder if this refrigerator would work as well:

[7] Seth Roberts has another long-term weight loss chart: This time the Shangri-La Diet comes out the best.

The Shangri-La Diet fits in with Stephan’s ideas, but makes a radical claim: that although eating tasteless calories causes weight loss, it’s not necessary that the whole diet be tasteless – only one spoonful a day is enough!

Seth’s ideas are incorporated into our weight loss recommendations indirectly. Our recommendation (Perfect Health Diet: Weight Loss Version, Feb 1, 2011) is to eat normal dietary levels of carbs and protein, reducing fat intake a bit but eating the usual Perfect Health Diet foods – but to eat intermittently with a daily 16-hour fast. During the fast, meet any hunger with a spoonful of coconut oil, Shangri-La Diet style.

[8] Bravo: Our view of obesity was superbly summarized by Stabby on Mark’s Daily Apple forum, and then reduced to a pithy aphorism by NourishedEm:

Stabby: Perfect Health Diet strives for…well…perfection in health and what follows from that? Better body composition.… [O]besity is a disease of metabolic syndrome, and eating a healthy diet can help in reversing it. The general mindset of someone trying to lose weight is that they would like as much of it gone as quickly as possible, but as always with everything it is the sustainability of things that ultimately matters. When we make health numero uno we put ourselves on the best possible path for the future.

NourishedEm: You don’t need to lose weight to get healthy, you need to get healthy to lose weight.

[9] I love this photo: The Hadza of Tanzania:

From National Geographic via Conditioning Research.

[10] Willie Mays turns 80 today: Here’s his famous catch:

[11] As if we needed more reason to avoid prostate exams: Biopsies are causing dangerous infections:

Studies emerging during the past year have uncovered that a small, yet growing percentage of those undergoing routine needle biopsy tests are becoming critically ill and dying from bacterial infections…. Nine out of 10,000 men whose tests were negative died within a month, researchers in Toronto reported in the Journal of Urology in March last year….

When he looked at hospital admissions among patients whose biopsy was negative for cancer, Nam discovered the chance of being hospitalized within a month of the procedure had increased fourfold in less than a decade, reaching 4.1 percent in 2005 from 1 percent in 1996, according to the Journal of Urology report.

When Nam searched for the cause of the hospitalizations, he found 72 percent had an infection-related diagnosis.

[12] Post of the week: In a week with some great competition, anthropologist Peter Frost of Evo and Proud wins the prize with a really interesting post on Candida infections. He presents evidence that a few substrains of Candida, which thrive in the mouth and vagina, have evolved an ability to infect the brain and induce a preference for sexual activity in “non-Euclidean” geometries. Startling if true. Of course, it’s only a matter of time before many pathogens evolve these abilities.

[13] Shou-Ching’s Photo-Art: This week’s installment – click to enlarge:

[14] But do the computers have health insurance?: Scientists afflict computers with schizophrenia to better understand the human brain:

Computer networks that can’t forget fast enough can show symptoms of a kind of virtual schizophrenia, giving researchers further clues to the inner workings of schizophrenic brains, researchers at The University of Texas at Austin and Yale University have found.

Pouring corn oil and sugar into the computer also impairs it, giving further clues to the origin of mental illness.

[15] Not the weekly video: The ultimate dog tease:

Via Bix.

[16] Video of the week: The Coral Triangle is a huge area centered on the Indonesian archipelago. The Bajau are a people who not only maintain Paleolithic lifeways – they live much their lives at sea. The Bajau are often hard of hearing due to intentionally puncturing their eardrums to facilitate diving. This video is mainly about conservation, but I thought the parts about the Bajau were most interesting:

People of the Coral Triangle from James Morgan Photography on Vimeo.

The conservation part touches upon a topic that came up in the comments last week, in which Peter argued that to save fisheries we need a system of oceanic property rights. Someone in the film (at 10:25) makes the same point in different words:

In order to enact a really sustainable and meaningful conservation program for the Coral Triangle region, we need to empower groups such as the Bajau to look after and curate their own environment.

Video via Barry Ritholtz.