Yearly Archives: 2011 - Page 36

Around the Web; Eating Disorders and Hypothyroidism

Posted by on February 19, 2011 37 comments

Items that caught my eye this week:

(1) Would You Be My Meatheart?: I wasn’t clever enough to give this to Shou-Ching for Valentine’s Day, but would have known to use genuine hearts from the Asian market. Wait till next year honey!

(2) By the way: Who knew Manolo has a food blog?

(3) Ronaldo Forced Out of Soccer for Lack of Thyroid Hormone. Famed soccer star Ronaldo is retiring because he has hypothyroidism and he says soccer authorities consider treatment to be doping – so he has to retire to fix his health.

Absurd! Mary Shomon agrees.

(4) Ronaldo may play the “beautiful game,” but we Americans play the crazy game. This running back plays football like I used to:

(5) Startling if True: Paleo Pepper abridges a talk by Dr. Flechas at iodine4health.com claiming that thyroid hormone replacement may actually increase risk of breast cancer among hypothyroid women – what is needed is high-dose iodine:

A women with hypothyroidism has a 6% chance of developing breast cancer. Once she starts taking thyroid hormone, it doubles her chances. Once she’s been on thyroid hormone replacement for 15 years, it more than triples it – she now has a 19.6% chance of developing breast cancer.

I have not seen such statistics before and would have to check these claims. We recommend iodine and selenium as the first steps in dealing with hypothyroidism, but generally support thyroid hormone replacement.

(6) Burying the Lede: Is “strengthens pelvic floor muscles” really the number one benefit?

(7) Another Perfect Health breakfast idea: Emily suggests cream of rice with cream, butter, and apricot applesauce.

(8) Paleolithic Dairy?: Ravi at Daia Sol Gaia argues that dogs may have been domesticated and goats tamed and used for milk as early as 35,000 years ago – the start of the Upper Paleolithic. Is goat milk a Paleo food?

(9) The authentic way to drink Paleo goat milk: Paleolithic settlers at Gough Cave in England, c. 13,000 to 10,000 BC, ate human bone marrow and brain and used the skulls as drinking chalices:

Via Dienekes. Apparently drinking from human skulls is a widely attested practice, both in Paleolithic and historical times – see e.g. the Krum and Herodotus’s Scythians.

Reference: Bello SM et al. Earliest Directly-Dated Human Skull-Cups. PLoS ONE 6(2): e17026. doi:10.1371/journal.pone.0017026. Link.

(10) Avoid vegetable oils if you want a baby: Chris Highcock found a paper showing that infertile women eat 23% more polyunsaturated fat, and 17% less saturated fat, than fertile women. Infertile men eat 20% more polyunsaturated fat than fertile men.

Reference: Revonta M et al. Health and life style among infertile men and women. Sex Reprod Healthc. 2010 Aug;1(3):91-8. http://pmid.us/21122604.

(11) Never give up:

“I had the head doctor of surgical I.C.U. say, ‘Miracles happen.’“

(Via Craig Newmark)

(12) Which Machine for the Hippo? I thought this was a cool picture:

(From NPR via John Durant)

(13) Finally, our video: We’ve had a bit of discussion of eating disorders this week, in the comments to the “Therapy AND Life” post. That reminded me of this CBS News interview of a “Biggest Loser” contestant who said she developed an eating disorder during the show:

Therapy AND Life

Posted by on February 17, 2011 102 comments

UPDATE: The Daily Mail article cited below was not only silly, it appears to have been dishonest. I’ve received the following email:

There is an article on your website about me (17/2/2011). Yes, I’m Judith Fine and that article was in the Daily Mail. Firstly, they completely twisted everything that I said so that it makes it look as if I have severe eating problems. Most of that article was a complete pack of lies, neither is it me in the photograph. Could you please, immediately remove it from you website as I am in the process of picking this up with the Daily Mail.

I’ve edited the post to remove content related to Judith. — PAJ

“Orthorexia” has been in the news recently, for instance in this Valentine’s Day article by Diana Appleyard in the Daily Mail:

We all know the type. They never let wheat, yeast or dairy pass their lips. They’ve cut out alcohol and caffeine. They’re obsessed with healthy eating — yet every day, they look more unwell and unhappier.

These are the symptoms of a condition called ‘orthorexia’ by dieticians….

Orthorexia was coined in 1997 by Californian doctor Steven Bratman in his book Health Food Junkies, and means ‘correct appetite’ (from the Greek orthos for right and orexis for appetite). It is a fixation with eating ‘pure’ food that, far from doing you good, can become so extreme that it leads to malnutrition, chronic ill health and depression.

Well, I don’t eat wheat; I didn’t even know yeast was a food; and though dairy is a big part of my diet, alcohol and caffeine modest parts, I recognize that milk proteins, alcohol, and caffeine can be problematic.

Given that none of these foods are necessary for good health, it’s not obvious to me why excluding them would lead to malnutrition, chronic ill health and depression.

But from the rest of the article, it looks like the real trouble with orthorexia is not the fixation with healthy eating, but faulty ideas of what constitutes a healthy diet. The article’s leading example of an unhealthy “orthorexic” diet is one that excludes fat.

Any fat-less diet is bound to be malnourishing. Perhaps the trouble is not orthorexia, but mistaken ideas about nutrition. Diets people think are therapeutic are, in fact, damaging.

Therapy versus Life … sometimes

Which brings me to a recent essay by Kurt Harris, “Therapy versus Life.”

It’s almost impossible to excerpt, so I’ll just assume you’ve read it. It’s strongly worded, but the ideas are familiar:  I suspect at least 90% of medical doctors would agree.

Doctors are healers, God bless ’em; but every day they have to face patients they cannot heal. This breeds a certain mental toughness.

As I often say, malnutrition, food toxins, and chronic infections are the primary causes of ill health. In some cases, like Judith Fine’s inability to have periods, it’s easy to recognize malnourishment as a likely cause. But the causes of most patients’ impaired health are much less obvious.

Unfortunately, doctors generally cannot diagnose or treat either bad diets or chronic infections. Doctors are great at treating acute disease, and can mitigate many symptoms that chronic diseases generate, but most are helpless to remedy mild, chronic ill health.

Doctors may believe that a patient’s declining health is simply natural aging; or that genuine health impairments may be undiagnosable, untreatable, or incurable. Kurt says it in his forum:

[T]he healthy should not assume they are sick and even the sick may be wasting their time trying to fix what can’t be fixed.

When patients learn that doctors can’t help them, they often turn to experimental self-treatment.

99% of the time, this works out badly. As Kurt’s car metaphor shows, there are many more ways to damage your body than to heal it.

And the 1% of the time it works, the patient doesn’t go tell the doctor. But when it backfires, the patient goes back to the doctor worse than ever. So the doctors see this method fail 100% of the time.

This reinforces the doctors’ consensus: Be prudent. Try to live normally – as healthy people do. Eat like healthy people, live like healthy people, and bear with your incurable maladies as best you can. Thrashing and groping for cures will only do harm.

Therapy – experimental self-therapies – are damaging to life. Choose life, not therapy.

But Diet Is Therapy

But that’s not all there is to it … because the right diet can fix many health problems.

Kurt says this himself:

[T]here is a dietary metabolic milieu that we are adapted to, and the best chance we have of optimizing our health is to try and emulate it …

The human body often can [fix itself] if we just stop ruining it.

We agree. The Perfect Health Diet is, in essentials, identical to Kurt’s PaNu. And when people in ill health eat this way, they commonly get better.

So the right diet is therapy. Choose this diet as therapy, and you’ll have a better life.

What If Your Life is Malady-Inducing?

I chose life over therapy for decades. I rarely went to the doctor. I focused all my energy on life. But I ate a lousy diet.

This isn’t the place to tell my story – that’s coming – but a lousy diet and a focus on life, not therapy, gave me a disabling chronic disease.

And a therapeutic diet gave me my life back. The Four Steps of our book are essentially the steps I took to cure a disabling neurodegenerative condition. With antibiotics, they worked.

So when Kurt asks,

Do you think every problem in your life can be fixed by changing your diet?

I can honestly say: every health problem was fixed!

Therapy for Life

If the Ewald hypothesis and Jaminet corollary are right, then we all stand in need of dietary therapy. As we age, our infectious burden increases and our immune system gets less effective. Sooner or later, infectious diseases threaten us all.

Our rescue is not from medicine, which does not yet know how to treat chronic infections. Our best chance for a long, healthy life lies in diet, nutrition, and immunity-enhancing behaviors like fasting.

Fortunately, the scientific evidence is accumulating to tell us what the right diet is. Specialist professionals still can’t see the forest for the trees, the elephant for its parts; but generalists, aided by respect for ancestral/traditional diets and for evolutionary selection, have blazed the trail. Kurt lists some reliable guides.

Conclusion

Diet is the best therapy. A good diet is life-giving. Good diet and nutrition may cost a few extra minutes a day, but can add decades of happiness.

So I say: choose therapy AND life. We can be healthy centenarians together. Let’s do it!

Evidence for Jaminet’s Corollary

Posted by on February 15, 2011 24 comments

Note to Abby: I did get distracted. Lemon juice next week.

In Friday’s post, I offered Jaminet’s Corollary to the Ewald Hypothesis. The Ewald hypothesis states that since the human body would have evolved to be disease-free in its natural state, most disease must be caused by infections. A consequence of the Ewald hypothesis is that, since microbes evolve very quickly, they will optimize their characteristics, including their virulence, depending on the human environment. If human-human transmission is easy, microbes will become more virulent and produce acute, potentially fatal disease. If transmission is hard, microbes will become less virulent, and will produce mild, chronic diseases.

Jaminet’s corollary is that such an evolution has been happening over the last hundred years or so, caused by water and sewage treatment and other hygienic steps that made transmission more difficult. The result has been a decreasing number of pathogens that induce acute deadly disease, but an increasing number that induce milder, chronic, disabling disease.

Indeed, most of the diseases we now associate with aging – including cardiovascular disease, cancer, autoimmune diseases, dementia, and the rest – are probably of infectious origin and the pathogens responsible may have evolved key characteristics fairly recently. Many modern diseases were probably non-existent in the Paleolithic and may have substantially changed character in just the last hundred years.

I predict that pathogens will continue to evolve into more successful symbiotes with human hosts, and that chronic infections will have to become the focus of medicine.

Is there evidence for Jaminet’s corollary?  I thought I’d spend a blog post looking at gross statistics.

When did hygienic improvements occur?

Since the evolution of pathogens should have begun when water and sewage treatment were adopted, it would be good to know when that occurred.

Historical Statistics of the United States, Millennial Edition, volume 4, p 1070, summarizes the history as follows:

[I]n the nineteenth century most cities – including those with highly developed water systems – relied on privy vaults and cesspools for sewage disposal…. Sewers were late to develop because at least initially privy vaults and cesspools were acceptable methods of liquid waste disposal, and they were considerably less expensive to build and operate than sewers.

Sewers began to replace privy vaults and cesspools as running water became more common and its use grew. The convenience and low price of running water led to a great increase in per capita usage. The consequent increase in the volume of waste water overwhelmed and undermined the efficacy of cesspools and privy vaults. According to Martin Melosi, “the great volume of water used in homes, businesses, and industrial plants flooded cesspools and privy vaults, inundated yards and lots, and posed not just a nuisance but a major health hazard” (Melosi 2000, p 91).

Joel Tarr also notes the impact of the increasing popularity of water closets over the later part of the nineteenth century (Tarr 1996, p 183). Water closets further increased the consumption of water, thus contributing to the discharge of contaminated fluids.

The data is not really adequate to tell when the biggest improvements were made. The most relevant data series, Dc374 and Dc375, begin only in 1915. They show that investments in sewer and water facilities were high before World War I, fell during the war and post-war depression, were very high again in the 1920s, and fell again after the Great Depression. It’s likely that the peak in water and sewage improvements occurred before 1930. In constant dollar terms, investment in water facilities peaked in 1930 at 610 million 1957 dollars and didn’t reach that level again until 1955. Investment in sewer facilities peaked at 734 million 1957 dollars in 1936 – probably due to Depression-era public works spending – and didn’t reach those levels again until 1953.

It seems likely that hygienic improvements were being undertaken continuously from the late 1800s and were probably completed in most of the US by the 1930s; in rural areas by the 1960s. Systems to deliver tap water were built mostly in the last quarter of the 19th century and first half of the 20th. The first flush toilets appeared in 1857-1860 and Thomas Crapper’s popularized toilet was marketed in the 1880s.

Mortality

Historical Statistics of the United States, Millennial Edition, volume 1, p 385-6, summarizes the trends in mortality as follows:

Recent work with the genealogical data has concluded that adult mortality was relatively stable after about 1800 and then rose in the 1840s and 1850s before commending long and slow improvement after the Civil War. This finding is surprising because we have evidence of rising real income per capita and of significant economic growth during the 1840-1860 period. However, … urbanization and immigration may have had more deleterious effects than hitherto believed. Further, the disease environment may have shifted in an unfavorable direction (Fogel 1986; Pope 1992; Haines, Craig and Weiss 2003).

Of course, urbanization and a worsening of the disease environment would be expected to coincide: with lack of hygienic handling of sewage, cities were mortality sinks throughout medieval times and that would have continued into the 19th century. Under the Ewald hypothesis, we would expect microbes to have become more virulent as cities became more densely populated in the 1840s and 1850s.

We have better information for the post-Civil War period. Rural mortality probably began its decline in the 1870s becaue of improvements in diet, nutrition, housing, and other quality-of-life aspects on the farm. There would have been little role for public health systems before the twentieth century in rural areas. Urban mortality probably did not begin to decline prior to 1880, but thereafter urban public health measures – especially construction of central water distribution systems to deliver pure water and sanitary sewers – were important in producing a rapid decline of infectious diseases and mortality in the cities that installed these improvements (Melosi 2000). There is no doubt that mortality declined dramatically in both rural and urban areas after about 1900 (Preston and Haines 1991).

The greatest improvements in mortality occurred between 1880 and 1950. Here is life expectancy at birth between 1850 and 1995 (series Ab644):

Life expectancy was only 39.4 years in 1880, but increased to 68.2 years by 1950 – an increase of 28.8 years. In the subsequent 40 years, life expectancy went up only a further 7.2 years.

Causes of Death

From Table Ab929-951 of volume 1, we can get a breakdown of death rates by cause from 1900 to 1990. Here are death rates from various infectious diseases:

And here for comparison are death rates from cancer, cardiovascular and renal diseases, and diabetes:

Overall, death rates have declined, consistent with rising life expectancy. However, death rates from chronic diseases have actually increased, while death rates from acute infections have, save for influenza and pneumonia, gone pretty much to zero.

Conclusion

Death rates from acute infections plummeted in the period 1880 to 1950 when hygienic improvements were being made. By and large, these decreases in infectious disease mortality preceded the development of antimicrobial medicines. Penicillin was discovered only in 1928, and by then mortality from infectious diseases had already fallen by about 70%.

We can’t really evaluate the Jaminet corollary from this data, other than to say that the data is consistent with the hypothesis. Nothing here rules out the idea that pathogens have been evolving from virulent, mortality-inducing germs into mild, illness-inducing germs.

Sometime later this year, I’ll look for evidence that individual pathogens have evolved over the last hundred years. It should be possible to find evidence regarding the germs for tuberculosis and influenza, since those continue to be actively studied.

There is great concern over the evolution of antibiotic resistance among bacteria. This data suggests that antibiotic resistance will not generate a return to the high mortality rates of the 19th century. Those mortality rates were high not due to a lack of antibiotics, but due to a lack of hygiene that encouraged microbes to become virulent.

As long as we keep our hands and food clean and our running water pure, we can expect mortality rates to stay low. Our problem will be a growing collection of chronic diseases.

Our microbes will want to keep us alive — that is good. But they will increasingly succeed at making us serve them as unwilling hosts. We will be increasingly burdened by parasites.

Diet, nutrition, and antimicrobial medicine are our defenses. Let’s use them.

Dong Po’s Pork

Posted by on February 13, 2011 13 comments

Su Dong Po is one of the two or three most beloved poets in Chinese history. So famous was he that the dish he loved most was given his name: Dong Po’s Pork.

It’s quite a treat: you’ll be unsure whether you’re eating the entrée or the dessert. Strangely this dish, one of the most popular in Chinese cuisine, rarely appears on the menu of Chinese restaurants in the U.S.

Preparing the Pork Bellies

Dong Po’s Pork is basically a high-class way of cooking pork bellies – the uncured precursor to bacon.

Buy the pork bellies in thick slices – at least a half-inch thick. Cut them into cubes about 1 inch on a side. You’ll also need a few slices from a ginger root and scallions:

The first step is to boil a pot of water. Add the cubed pork bellies, ginger, and scallion to the boiling water.

Boil for 30 minutes, it will look like this:

Drain the liquid, keeping the solids.

This boiling process removes unpleasant pork flavors, and leaves the pork with a very mild fatty flavor.

Preparing the Sauce

While the pork is being boiled, prepare the cooking sauce. Mix in a small bowl about 2 tbsp soy sauce – we use Kikkoman Teriyaki Marinade and Soy Sauce, but any naturally brewed soy sauce can be used – and a half cup of wine – we used Riesling since we frequently drink that, but any wine will do. Also, cut more ginger and scallions. The traditional Chinese recipe calls for star anise as well:

If whole star anise is unavailable, you can find ground anise or Chinese “5-star” spice in your supermarket spice aisle. However, it would also come out fine if you dispense with the anise; the pork, soy sauce, wine, and caramelized sugar provide most of the taste.

Traditionally, the remainder of the cooking would be done in a Dutch oven or similar pot that retains heat and can be tightly sealed to keep in steam. However, we’ll use a wok.

In the wok, warm some cooking fat. You can use any oil you like – olive oil or coconut oil are fine. We have been using beef tallow lately – here we are melting some fat from a block of beef fat:

Once the oil is warm, add about 2 tbsp rice syrup. Stir as the sugar caramelizes. It’s ready as soon as bubbles appear — about 30 seconds:

We have adopted rice syrup as our sweetener of choice. It is a zero-fructose sweetener, and we like that it provides glucose calories along with its sweet taste: it seems the body evolved to expect sweet tastes to be followed by an infusion of sugar, since zero-calorie sweeteners trigger insulin release. We like our food to fit the body’s evolved expectations. (The traditional sweetener is smaller amount of brown sugar.)

Caramelizing sugar will create some advanced glycation endproducts (AGEs), so this dish is not perfectly healthy – but it is healthy enough for us.

Completing the Dish

Immediately after the rice syrup begins to caramelize, and before it burns, add the cooked pork to the pan and stir to coat the pork evenly.

Then immediately add all the other ingredients.

Cover, briefly raise the heat to bring the wine and soy sauce mixture to a simmer, then lower the heat and let it simmer covered for 30 to 60 minutes.

The object here is to steam the pork and let the sauce flavors combine with the pork. The longer you steam it, the softer the fat becomes and the more it melts in your mouth.

Every 10 to 15 minutes, uncover and stir. If your soy sauce was not salty enough for you, you can add a bit of salt while it is cooking.

By the time you’re done, there will be only a little liquid left. Transfer to a serving bowl.

Dong Po Pork is fantastic with rice. Here’s how we ate it:

Enjoy!