Author Archives: Paul Jaminet - Page 42

Ask Me Anything at Reddit Tuesday noon

Posted by on March 4, 2013 28 comments

Just a brief reminder – I’ll be doing an Ask Me Anything at Reddit at noon Eastern time on Tuesday. To join in, visit http://www.reddit.com/r/iama/. Thank you to Sol Orwell for organizing this. UPDATE: The thread is here: http://www.reddit.com/r/IAmA/comments/19pqti/hi_i_am_paul_jaminet_author_with_my_wife_of/

On Saturday, Shou-Ching and I will be speaking and signing books at Relentless Fitness in downtown Philadelphia. We’ll be taking a few vacation days around it and so our next blog post might be delayed into next week. Thank you very much to Roger Dickerman and Grace Rollins for organizing Saturday’s event, which is full. We’re excited to have an opportunity to meet our Philadelphia readers!

Okonomiyaki (Japanese pizza-style pancake)

Posted by on March 3, 2013 33 comments

KH left a note on the Recipes page about Okonomiyaki, a Japanese pancake. Our 17-year old niece Seo Yi, who is visiting from Korea, said, “I know how to make that!” We decided to give it a try.

In Asia, pancakes are eaten as we eat pizza or omelettes – as an all-purpose meal that can have an assortment of ingredients. Feel free to substitute ingredients at will; but this assortment worked very well for us.

Ingredients

The only unusual ingredient you need is yamaimo, the Japanese mountain yam. Yamaimo is also called nagaimo (or two words, yama imo or naga imo); or, can be called Chinese yam or Korean yam or even “slimy potato.” When grated, yamaimo releases a sticky liquid that helps the pancake stick together.

The ingredients may be divided into three groups. The first group makes a batter. We recommend:

  • 100 g (2/3 cup) gluten free flour
  • 1 tsp baking powder
  • 100 ml (1/3 cup) bone broth
  • 2 eggs
  • Yamaimo (Japanese mountain yam)

The second group provides the vegetables and meats or seafood that make it a meal. We recommend:

  • cabbage (2-3 leaves)
  • green onion (2-3 stems) or onion (1 medium)
  • shrimp (5 large)
  • scallops (6 medium)
  • shiitake mushrooms (6)
  • sweet pickled ginger (optional)
  • salt and pepper

Finally an assortment of toppings are added either during cooking or after cooking is done. We recommend:

  • bacon (added during cooking)
  • sour cream (added after cooking)

Other sauces — okonomiyaki (Chuno) sauce, spicy (Sriracha) sauce – and toppings (eg, dulse or bonito flakes) may be added to your taste. We wouldn’t go out of our way to pick up the Japanese sauces; but we consider the extra fat from the bacon and sour cream to be important, as the brings the macronutrient proportions in line with PHD recommendations and improve the taste.

We made several batches with slightly different sets of ingredients. Here are a few pictures of non-meat ingredients:

Cabbage leaves, eggs, green onion, gluten-free flour, yamaimo section, sweet pickled ginger..

Cabbage leaves, eggs, grated mozzarella cheese (as we mentioned, you can add almost any ingredient), yamaimo, gluten-free flour, baking powder, onion, shiitake mushroom.

And here are the meats we favor – bacon, scallops, and shrimp:

Preparation

Mix the gluten-free flour, baking powder, bone broth, and eggs in a mixing bowl. Peel the Yamaimo and grate it directly over the mixing bowl, releasing its sticky fluid into the batter. Mix well.

Cut the vegetable and meat ingredients into small pieces and mix into the batter. It will start to look like this:

These ingredient amounts will make enough batter for one very large pancake (filling a wok or griddle) or two smaller pancakes.

Warm a wok or griddle at medium heat and add a tablespoon of butter to grease the pan. Pour in the batter and reduce the heat to medium-low.

A large pancake will require ten minutes per side at medium-low heat, smaller pancakes will require about five minutes per side. While the first side is cooking, lay bacon over the top of the pancake and add some batter over the top to help seal the bacon in:

When the first side is sufficiently cooked, flip the pancake and cook the other side. Here is a smaller size pancake – note that it doesn’t fill the pan:

When finished, the large pancake looks like this:

Here is a smaller pancake on a serving plate:

Cut the pancake into slices like a pizza and serve with sour cream:

Or with sour cream and okonomiyaki sauce:

Variations

Any number of meats, toppings, and sauces can be added. Some cooks add potato chips to give the pancake a crunchy texture; we tried this once and it didn’t improve the taste, so we don’t recommend including potato chips.

Here is one variation — so easy a dog can do it! Watch how the Yamaimo releases its sticky fluid when grated:

Conclusion

Okonomiyaki is delicious, is an Asian street standard, and yet most Americans have never tried it. Asians love pancakes, and you’ll know why after trying this!

What Causes Acne? An Overview

Posted by on February 27, 2013 193 comments

I’ve been promising a series on acne and rosacea for almost two years, but I’ve had trouble working up enthusiasm for it. The problem is that Pubmed has 12,966 papers on acne and 2,587 papers on rosacea, most of those papers are of poor quality, and it is painful to sift through the dross in search of gold.

Fortunately, Seppo Puusa, who blogs at the Acne Einstein, has offered to help. Seppo’s a very smart guy and I thought a conversation between us about acne and rosacea might be an interesting way to do the series.  Seppo has just written a book called Clear for Life: Science-Based Natural Acne Treatment Program, which looks like a terrific guide to overcoming acne. In this first post in our acne and rosacea series, Seppo gives us his overview of acne. Here’s Seppo!

Does it ever feel like acne is just maddeningly confusing? That it just comes and goes without making any sense? It’s almost as if acne is not one disease but a combination of many diseases. For example one person gets acne from eating gluten, while another claims she can eat whatever she wants but breaks out every time she uses certain skin care products. A third person puts the blame on stress. Another person said zinc supplements helped her to get clear.

Is there a way to make sense of this, to reconcile all these seemingly separate causes? I believe there is. And in this post I’ll do my best to give you a framework for understanding acne. Something that ties all these seemingly separate causes together and helps you to make sense of your acne.

Deconstructing acne

In Tim Ferris’s latest book The Four Hour Chef he explains how to use deconstruction to learn a new skill. Basically you boil the skill down to its bare essentials. In acne these are inflammation and hormones (insulin to be more specific).

Let me start by explaining the pimple formation process. Looking at what happens in your skin is important because, surprisingly, understanding this helps you to understand how diet, gut issues, stress and other things can cause acne. Acne is more than skin-deep, but it still happens at the skin.

In acne, skin cells produce too much keratin, a protein that’s the key structural component of your skin, hair and nails. In the skin it holds skin cells together. Normally as skin cells die they separate and are pushed out of the hair/skin follicle (I’ll just call this a “skin pore” from now on). But the excess keratin makes it harder for the dead cells to separate so they are shed in larger lumps. [1]

These lumps of dead skin cells can block the skin pore, and this block prevents sebum from flowing out. One study showed that acne-prone skin produces about 3 times more sebum than normal skin [2], though other studies have found somewhat smaller differences [3, 4]. Now this torrent of sebum flows into the blocked pore and has nowhere to go. So the skin pore expands, like what happens when you blow into a balloon. Oxygen content drops in the blocked pore, and this helps the bacterium P. Acnes to thrive in the blocked pore [5]. The rest you probably know: the immune system responds and causes inflammation in the area.

This process has two breakpoints — points at which we can intervene to prevent or lessen acne. These are:

  • Excess keratin production
  • Excess sebum production

Counter either, or both, of these and your chances of getting acne go down dramatically. And here is where inflammation and hormones comes into play. Because research shows that inflammation in the skin and hormonal factors are the key drivers in both excessive keratin and sebum production.

Inflammation

Many people think of acne as bacterial disease, but more than anything it’s an inflammatory problem. Many researchers now believe that inflammation in the skin is the trigger that kicks off the whole process. Studies have shown that inflammation is present in the very earliest stages of a pimple, even before P. Acnes bacteria colonizes the skin pore [6, 7]. Cell culture studies also show that inflammatory cytokines increase both sebum and keratin production [1,8]. Finally, several studies have shown that antioxidants, whether topical and supplemental, can be as effective as benzoyl peroxide or antibiotics in treating acne [5,9]; this is consistent with the inflammatory view because oxidative stress can trigger inflammation.

Hormones

Acne has been conclusively linked to elevated levels of androgens, insulin, and insulin like growth factor 1 (IGF-1). These hormones stimulate sebum production and there’s some research to suggest they also affect keratin production. [1]

The relationship between acne and hormones is quite complicated. Androgens, or male sex hormones, are arguably the primary hormones affecting the skin. It has been shown that acne does not occur in people with inactive androgen receptors in the skin [10].

However, acne patients do not necessarily have higher levels of androgen hormones than people with clear skin. A portion of acne patients seem to have higher levels of some androgen hormones, but this is far from universal. Rather, acne-prone skin seems to be excessively sensitive to androgen hormones.

Insulin and IGF-1 are key hormones in acne. That’s because while androgens mediate lot of the effects on the skin, insulin and IGF-1 are the hormones you have the most control over. I like to call insulin a booster hormone in acne. And where there’s insulin, there’s also IGF-1. That’s why I group these two hormones together. [11]

Insulin and IGF-1 can stimulate sebum production on their own, but they also stimulate the release of androgen hormones from the liver and can increase the skin’s sensitivity to androgen hormones. That’s why studies show low GI diets can help with acne, and why milk can be so bad for the skin. [1, 11]

How sebum production drives antioxidant demand

The skin is the most exposed of all the organs. It’s frequently exposed to UV radiation, ozone from air pollution, bacteria, dust and other ‘inflammatory insults’. So the skin needs constant protection, and that protection comes in the form of antioxidants. In the skin the antioxidants are primarily in sebum. [12]

Research shows a tight correlation between sebum production and vitamin E secretion by the skin [13]. More specifically vitamin E secretion correlates with squalene secretion. Squalene is a fatty acid and a part of sebum. It really looks like the body uses vitamin E to protect squalene in the skin. When squalene oxidizes it turns into squalene peroxide, a highly inflammatory and comedogenic fatty acid. Animal studies show that applying squalene peroxide on the skin causes acne, and the severity of acne is linked to the degree of oxidation of squalene [5].

So the more sebum your skin produces the more antioxidants it requires. There’s good evidence to show that the antioxidant system in acne patients just can’t cope up with this increased demand. For example comparing skin and blood levels of several antioxidants shows significantly lower levels in acne patients than in people with healthy skin. [5, 9]

This is the factor that, I believe, ties together all those seemingly disparate factors that can trigger or relieve acne:

  • Gut problems increase systemic inflammation and deplete antioxidant reserves leading to more acne.
  • Stress triggers the release of neurotransmitters (such as substance P) that can increase inflammation in the skin leading to more acne [1].
  • Diet can induce or relieve inflammation leading to more or less acne. Diet also affects insulin levels.
  • Supplementing with zinc or other nutrients can provide antioxidants which lessen acne [14].
  • Candida and other pathogens in the skin cause local inflammation which can induce acne.

Conclusion

Acne is a very complicated condition and I don’t for one second pretend that this simple framework perfectly explains every case. Individual differences exist, and things get much more complicated when we get down into details. But I do believe it’s a good big picture overview of what causes acne and hopefully clears some confusion surrounding it.

Most importantly, this framework is broadly actionable. It gives you a systematic way to approach acne. Anything you can do to lower insulin and inflammation (both systemic and local in the skin) can help in acne.

Just remember, where there’s insulin there’s oily skin, and where there’s inflammation there’s acne.

References

  1. Ichiro Kurokawa, et al. New developments in our understanding of acne pathogenesis and treatment. Experimental Dermatology. Volume 18, Issue 10, pages 821–832, October 2009. http://onlinelibrary.wiley.com/doi/10.1111/j.1600-0625.2009.00890.x/full
  2. Harris HH, et al. Sustainable rates of sebum secretion in acne patients and matched normal control subjects. J Am Acad Dermatol. 1983 Feb;8(2):200-3. http://www.ncbi.nlm.nih.gov/pubmed/6219137
  3. S-W. Youn, et al. Does facial sebum excretion really affect the development of acne? British Journal of Dermatology. Volume 153, Issue 5, pages 919–924, November 2005. http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2133.2005.06794.x/full
  4. Apostolos Pappas, et al. Sebum analysis of individuals with and without acne. Dermatoendocrinol. 2009 May-Jun; 1(3): 157–161. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2835908/
  5. Whitney P Bowe, Alan C Logan. Clinical implications of lipid peroxidation in acne vulgaris: old wine in new bottles. Lipids in Health and Disease 2010, 9:141. http://www.lipidworld.com/content/9/1/141
  6. Eady E, et al. Is Acne an Infection of Blocked Pilosebaceous Follicles?: Implications for Antimicrobial Treatment. American Journal of Clinical Dermatology. July/August 2000 – Volume 1 – Issue 4 – pp 201-209. http://adisonline.com/dermatology/Abstract/2000/01040/Is_Acne_an_Infection_of_Blocked_Pilosebaceous.1.aspx
  7. Anthony HT Jeremy, et al. Inflammatory Events Are Involved in Acne Lesion Initiation. Journal of Investigative Dermatology (2003) 121, 20–27; doi:10.1046/j.1523-1747.2003.12321.x. http://www.nature.com/jid/journal/v121/n1/full/5601829a.html
  8. Monica Ottaviani, et al. Lipid Mediators in Acne. Mediators Inflamm. 2010; 2010: 858176. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2943135/
  9. Bowe WP, et al. Acne vulgaris: the role of oxidative stress and the potential therapeutic value of local and systemic antioxidants. J Drugs Dermatol. 2012 Jun;11(6):742-6. http://www.ncbi.nlm.nih.gov/pubmed/22648222
  10. J Imperato-McGinley, et al. The androgen control of sebum production. Studies of subjects with dihydrotestosterone deficiency and complete androgen insensitivity. The Journal of Clinical Endocrinology & Metabolism February 1, 1993 vol. 76 no. 2 524-528. http://jcem.endojournals.org/content/76/2/524.short
  11. Melnik BC, Schmitz G. Role of insulin, insulin-like growth factor-1, hyperglycaemic food and milk consumption in the pathogenesis of acne vulgaris. Exp Dermatol. 2009 Oct;18(10):833-41. Epub 2009 Aug 25. http://onlinelibrary.wiley.com/doi/10.1111/j.1600-0625.2009.00924.x/full
  12. Jens J. Thiele, Swarna Ekanayake-Mudiyanselage. Vitamin E in human skin: Organ-specific physiology and considerations for its use in dermatology. Molecular Aspects of Medicine. Volume 28, Issues 5–6, October–December 2007, Pages 646–667. http://www.sciencedirect.com/science/article/pii/S009829970700057X
  13. Mauro Picardo, et al. Sebaceous gland lipids. Dermatoendocrinol. 2009 Mar-Apr; 1(2): 68–71. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2835893/
  14. Dreno B, et al. Multicenter Randomized Comparative Double-Blind Controlled Clinical Trial of the Safety and Efficacy of Zinc Gluconate versus Minocycline Hydrochloride in the Treatment of Inflammatory Acne vulgaris. Dermatology 2001, Vol. 203, No. 2 http://content.karger.com/ProdukteDB/produkte.asp?Aktion=ShowAbstractBuch&ArtikelNr=51728&ProduktNr=227730

Around the Web: A New Podcast and Bacterial Warfare

Posted by on February 25, 2013 28 comments

I apologize: I’ve fallen about three weeks behind in responding to the Q&A thread, as I’ve been trying to catch up on other work. I will try to get to all the old questions.

[1] New Podcast with Jonathan Bailor: I had the pleasure of recording a conversation with Jonathan Bailor, producer of The Smarter Science of Slim. I mentioned Jonathan’s new “Slim is Simple” video in my last Around the Web, but there’s more: he’s a terrific conversation partner and his podcast looks to be a great new entry among the leading Paleo podcasts. Check it out!

[2] Help Scholars Understand the Ancestral Health Movement: Historian Hamilton Stapell, who is active in the Ancestral Health Society, is researching the composition of the ancestral health movement. We’re making history, let’s help the historians understand what we’re doing. Please spend a few minutes to fill out his survey.

[3] Music to View Los Angeles By: Via Meredith Harbour Yetter on Facebook, Wilco does “California Stars”:

[4] Interesting Items:

If you’re looking for a new tumblr blog, try WTF, Evolution?.

If you’re looking for a familiar and funny one, re-visit What Should We Call Paleo Life.

MarksDailyApple found this article on barefoot horses doing well in competition. This sentence caught my eye: “Barefoot horses also need to have the sugar levels in their diet carefully managed.” Did horses need shoes because high-carb diets made their feet tender?

Brain cancer mortality increases with Toxoplasma gondii seroprevalence.

More evidence that a high-fat diet promotes longevity: Polish centenarians have high adiponectin.

Emily Deans presents more reasons to eat egg yolks, especially in pregnancy.

Via Dennis Mangan, more evidence that a high-fat diet is good for you: 41% fat is better for mood than 25% fat.

When trees die, humans do too.

Jack Peterson offers advice for undergraduate eating; and he’s interviewed a man who normally does the interviewing, Abel James.

Ray Medina approves of Bifidobacterium infantis.

The food reward idea is in the popular press; a journalist has written a new book on it, Salt Sugar Fat: How the Food Giants Hooked Us that is at #78 at Amazon.

Can you tell the profs from the hobos? (Via Craig Newmark)

Sustainable safe starches: Indian farmers are setting record yields growing rice and potatoes with a technique called System of Root Intensification (SRI), invented by a French Jesuit priest in Madagascar in the 1980s. However, a Chinese scientist questions the yield data.

Hitler was a vegetarian, he planned to convert Germany to vegetarianism after the war, and the Hitler Youth promoted soybeans by calling them Nazi beans. I’ll have to remember that name.

Coca-Cola – 10 liters a day of it – has been linked to a death.

Horsemeat is catching on in England.

Fish is better than fish oil: ProfDr Andro says phospholipid-borne omega-3s are better than triglyceride-borne omega-3s.

Lara Briden, N.D., suggests “gentle carbs” (similar to safe starches) for adrenal health.

Seth Roberts comments on a case in which arthritis was cured by dietary changes that successfully remodeled the gut flora.

Ned Kock wonders if testosterone levels are driven by cortisol.

Finally, orthorexia has become a hot topic on Broadway:

[5] Cute Animals:

Via Yves Smith.

[6] Bacterial Warfare: Here is an interesting video from the current issue of Cell. You may have heard that “tit-for-tat” is a successful strategy in repeated prisoner’s dilemma games – a type of game that resembles microbial competition in the human gut. Microbiologist John Mekalanos and colleagues observed the conditions under which microbes like Vibrio cholerae (whose more virulent strains cause diarrhea and cholera) and Pseudomonas aeruginosa (which is pathogenic in people with cystic fibrosis) choose to fight or co-exist with one another. Listen to Dr. Mekalanos explain bacterial warfare conducted with Type VI secretion systems:

For more, see “Bacterial Battlefield.”

By the way, Shou-Ching is currently working on a video paper showing how tumor cells interact with and attempt to take control of endothelial cells when they are co-cultured. If the paper is open-access, we’ll share her videos when the paper comes out.

[7] Silly Video: If animals had an epidemic that inflated them like beach balls, the Serengeti might look something like this:

[8] S*** Paleo People Say: PaleoFX is a month away, and I’m sure it will be just as fun as this video:

[9] Video of the Week: Lee Saxby discusses how to avoid injuries when running: