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What Telomeres Tell Us About Human Disease

Posted by Paul Jaminet on April 7, 2011 18 comments

We believe that almost all diseases are caused by food toxins, malnutrition, and infections. Toxic and malnourishing diets depress immunity and make infections worse.

Once you have this point of view in mind, supporting evidence is everywhere.

Take, for example, a story today in ScienceDaily about depression. Depression is not just a mental illness, but a whole body illness:

Previously considered a mental illness affecting only the brain, major depressive disorder, or MDD, now is believed to be tied to significant physical damage outside the brain, explained Wolkowitz. For example, depressed individuals are more likely to develop the diseases of advanced age, including diabetes, heart disease, osteoporosis, stroke and dementia. [1]

The ScienceDaily article summarizes new research showing a link between depression and telomere length in white blood cells. Telomeres are the end-caps on chromosomes. If telomeres become too short, DNA becomes unstable, genetic integrity is lost during cell division, and cells become senescent (crippled beyond hope of recovery) or commit apoptosis (suicide).

An enzyme called telomerase lengthen telomeres. Normally, most cell types maintain a balance between telomerase levels and replication so that telomeres are maintained at healthy lengths throughout normal cell life.

It turns out that in depressed people, white blood cell telomeres are shorter than in normal people, even though telomerase is more active. [2] Moreover, for a given telomere length, the more telomerase activity, the more depressed the patient. [3] Finally, telomerase activity predicts which patients will recover: patients who recovered from depression had the highest telomerase activity along with their short telomeres. [3]

This suggests that some exogenous factor, not part of normal human biology, is shortening telomeres in the depressed; and that the body’s capacity to resist this factor determines its ability to recover from depression. If the body can overcome the exogenous factor, eliminating its ability to shorten telomeres, then the depression goes away.

What could this exogenous factor be?

Telomeres and Viral Infections

Well, it happens that a number of viruses shorten telomeres in white blood cells.

Cytomegalovirus reduces telomere length in T cells:

After primary CMV infection, we observed … a steep drop in telomere length. Moreover, we found in a cohort of 159 healthy individuals that telomere shortening was more rapid in CMV-seropositive individuals and correlated with the amount of differentiated T cells in both CD4(+) T cells and CD8(+) T cells. [4]

The Epstein-Barr virus (EBV) is carried by more than 90% of the adult world population and has been implicated in several human cancers. [5] EBV disrupts the caps of telomeres, creating dysfunctional telomeres: “The telomere capping protein TRF2 was partially displaced from telomeres in EBV-infected cells, suggesting an EBV-mediated uncapping problem.” [5]

HIV also shortens telomeres: “Analysis of telomere length in HIV-1 exposed U373 showed a statistically significant telomere shortening” [6]. Interestingly, telomere shortening by HIV was reversed by providing N-acetylcysteine, suggesting that NAC should be beneficial for AIDS and possibly other chronic viral infections.

Connections between viruses and telomere loss run deep. In fact, it has been proposed that cellular senescence, the usual outcome of telomere loss, evolved as an anti-viral defense mechanism. [7]

If viruses cause major depression, then they probably also cause the diseases associated with depression. After all, they have to infect the rest of the body before they can infiltrate the brain. So we should look at viruses and other systemic diseases, and see if the connection with telomere shortening holds in those diseases.

Cancer and Blood Cell Telomeres

There is steadily increasing evidence implicating viruses as causes of cancers. Wikipedia (“Infectious causes of cancer”) has a summary:

Worldwide approximately 18% of cancers are related to infectious diseases…. Viruses are usual infectious agents that cause cancer but bacteria and parasites may also have an effect.

A virus that can cause cancer is called an oncovirus. These include human papillomavirus (cervical carcinoma), Epstein-Barr virus (B-cell lymphoproliferative disease and nasopharyngeal carcinoma), Kaposi’s sarcoma herpesvirus (Kaposi’s Sarcoma and primary effusion lymphomas), hepatitis B and hepatitis C viruses (hepatocellular carcinoma), and Human T-cell leukemia virus-1 (T-cell leukemias). Bacterial infection may also increase the risk of cancer, as seen in Helicobacter pylori-induced gastric carcinoma.[2] Parasitic infections strongly associated with cancer include Schistosoma haematobium (squamous cell carcinoma of the bladder) and the liver flukes, Opisthorchis viverrini and Clonorchis sinensis (cholangiocarcinoma).[3]

According to some authors, viruses are one of the most important risks factor for cancer development in humans, second only to tobacco use.[4]

This summary overlooks some known associations (such as that between XMRV and prostate cancer, see our post Retroviruses and Chronic Fatigue Syndrome, Aug 24, 2010) and evidence that tobacco use raises cancer risk primarily in people with a high viral infectious burden (see ref. [10] below). Although only 18% of cancers may yet have been confidently linked to infectious pathogens, it is not impossible that 100% of cancers are caused by as-yet-mostly-unidentified infectious pathogens, probably mainly viruses.

If viruses cause cancers, and if viruses shorten white blood cell telomeres, then we would expect cancer patients to have shortened telomeres.

Well, gastric cancer patients have shorter white blood cell telomeres, and being in the bottom half of telomere length doubles gastric cancer risk:

GC patients had significantly shorter average telomere length than matched controls (mean +/- SD 0.89 +/- 0.19 vs 1.06 +/- 0.25, P < 0.001)…. We found that short telomere length was associated with a significantly increased GC risk (adjusted odds ratio = 2.14, 95% confidence interval = 1.52-2.93)…. Collectively, our findings provide the first evidence linking the short telomere length in peripheral blood lymphocytes to elevated GC risk. [8]

Lung cancer patients have shorter white blood cell telomeres, and being in the bottom half of telomere length triples lung cancer risk:

Telomere length was significantly shorter in lung cancer patients than in controls (mean +/- standard deviation: 1.59 +/- 0.75 versus 2.16 +/- 1.10, P < 0.0001). When the subjects were categorized into quartiles based on telomere length, the risk of lung cancer was found to increase as telomere length shortened (P(trend) < 0.0001)…. [I]ndividuals with short telomeres were at a significantly higher risk of lung cancer than those with long telomeres (adjusted odds ratio = 3.15, 95% confidence interval = 2.12-4.67, P < 0.0001). [9]

Bladder cancer patients also had short white blood cell telomeres. Being in the bottom quarter of telomere length increases risk 4.5-fold, 6.3-fold for smokers:

Patients with bladder cancer displayed significantly shorter telomeres than control subjects (P = 0.001). Median telomere length ratio was 0.95 (range 0.53-3.2) for cases and 1.1 (0.51-2.4) for controls. Moreover, the adjusted odds ratio (OR) for bladder cancer was significantly increased in the quartile with the shortest telomere length OR = 4.5 [95% confidence interval (CI) 1.7-12]. [10]

Same story with head and neck cancer [11], renal cancer [12], breast cancer [13], and probably also thyroid cancer [14].

Cardiovascular Disease

A weakness of those cancer studies is that they only looked at blood cell telomeres and the presence of cancer; they didn’t also measure viral burden, for instance by looking for antibody seropositivity.

So I was pleased to find a study that did that in coronary heart disease. Again, white blood cell telomeres were shorter in heart disease patients:

Telomere length (TL) was approximately 0.5 kilobases (kb) shorter in leukocytes from patients with CHD than in their age-matched control subjects….

TL shortening was particularly pronounced in CD8+CD28(-) T cells obtained from cytomegalovirus-seropositive CHD patients. [15]

So cytomegalovirus may be involved in coronary heart disease.

The reason all these studies have looked at white blood cells is because it is easy to get blood samples. But sometimes it is possible to get samples from diseased and normal tissues and do a direct comparison.

That was done in this study of atherosclerotic plaques:

Arterial segments which did not develop atherosclerosis such as the saphenous vein and internal mammary artery, had longer telomere length than aortic segments. On the other hand, telomere length was shorter in aortic tissues which presented atherosclerotic lesions compared to corresponding tissues without atherosclerotic lesions. These results also suggest tissue regulation of telomere size by local factors likely related to oxidative stress responses.

So the normal vessels have long telomeres, indicating an absence of viral infections, but the atherosclerotic plaques have short telomeres, suggesting of high infectious burden.

Conclusion

Telomere shortening is probably a marker of infectious burden, especially of viral infections. Telomere shortening in blood cells is associated with major depression, cancer, heart disease, and probably nearly every other disease.

Diseases probably result from a combination of factors, but a heavy burden of chronic infectious pathogens is probably almost always one of them. These pathogens are usually little more than parasites, sapping nutrients from human cells and disabling their immune defenses. But combined with toxic and malnourishing diets, they cripple the body and shorten lifespan.

The association of shortened telomeres with shortened lifespan may be due to the life-shortening effects of infections.

This is why the immunity-enhancing dietary steps discussed in Step Four of our book are so central to a long and healthy life. We cannot avoid exposure to these pathogens. But we can keep their numbers down, so that they do minimal harm to us throughout life.

References

[1] University of California – San Francisco (2011, April 6). Link between chronic depression and accelerated immune cell aging. ScienceDaily. Retrieved April 7, 2011, from http://www.sciencedaily.com/releases/2011/04/110405151223.htm.

[2] Wolkowitz OM et al. Leukocyte telomere length in major depression: correlations with chronicity, inflammation and oxidative stress – preliminary findings. PLoS One. 2011 Mar 23;6(3):e17837. http://pmid.us/21448457.

[3] Wolkowitz OM et al. Resting leukocyte telomerase activity is elevated in major depression and predicts treatment response. Mol Psychiatry. 2011 Jan 18. [Epub ahead of print] http://pmid.us/21242992.

[4] van de Berg PJ et al. Cytomegalovirus infection reduces telomere length of the circulating T cell pool. J Immunol. 2010 Apr 1;184(7):3417-23. http://pmid.us/20176738.

[5] Lacoste S et al. Chromosomal rearrangements after ex vivo Epstein-Barr virus (EBV) infection of human B cells. Oncogene. 2010 Jan 28;29(4):503-15. http://pmid.us/19881539.

[6] Pollicita M et al. Apoptosis and telomeres shortening related to HIV-1 induced oxidative stress in an astrocytoma cell line. BMC Neurosci. 2009 May 22;10:51. http://pmid.us/19463156.

[7] Reddel RR. Senescence: an antiviral defense that is tumor suppressive? Carcinogenesis. 2010 Jan;31(1):19-26. http://pmid.us/19887513.

[8] Liu X et al. Constitutive telomere length and gastric cancer risk: case-control analysis in Chinese Han population. Cancer Sci. 2009 Jul;100(7):1300-5. http://pmid.us/19432888.

[9] Jang JS et al. Telomere length and the risk of lung cancer. Cancer Sci. 2008 Jul;99(7):1385-9. http://pmid.us/18452563.

[10] Broberg K et al. Constitutional short telomeres are strong genetic susceptibility markers for bladder cancer. Carcinogenesis. 2005 Jul;26(7):1263-71. http://pmid.us/15746160.

[11] Wu X et al. Telomere dysfunction: a potential cancer predisposition factor. J Natl Cancer Inst. 2003 Aug 20;95(16):1211-8. http://pmid.us/12928346.

[12] Shao L et al. Telomere dysfunction in peripheral lymphocytes as a potential predisposition factor for renal cancer. J Urol. 2007 Oct;178(4 Pt 1):1492-6. http://pmid.us/17707063.

[13] Shen J et al. Short telomere length and breast cancer risk: a study in sister sets. Cancer Res. 2007 Jun 1;67(11):5538-44. http://pmid.us/17545637.

[14] Capezzone M et al. Telomeres and thyroid cancer. Curr Genomics. 2009 Dec;10(8):526-33. http://pmid.us/20514214.

[15] Spyridopoulos I et al. Accelerated telomere shortening in leukocyte subpopulations of patients with coronary heart disease: role of cytomegalovirus seropositivity. Circulation. 2009 Oct 6;120(14):1364-72. http://pmid.us/19770396.

[16] Nzietchueng R et al. Telomere length in vascular tissues from patients with atherosclerotic disease. J Nutr Health Aging. 2011;15(2):153-6. http://pmid.us/21365170.

Causes and Cures for Constipation

Posted by Paul Jaminet on April 4, 2011 288 comments

Constipation seems to be very common; we’re frequently asked about it. Constipation can afflict low-carb dieters: It was widely reported among Atkins dieters, and is the most common side effect reported on clinical ketogenic diets for epilepsy. [1]

Fortunately constipation is usually easily cured. There are a few common causes, and most of them have simple fixes.

Antioxidant Deficiency

Among the most common causes of constipation among low-carbers is deficient antioxidant capacity.

The gut is a challenging environment, full of oxidizing compounds. If glutathione and other antioxidants become deficient in intestinal cells, then the gut becomes leaky [2], leading to inflammation and the potential for constipation. Oxidative stress can also lead to loss of neurons or neuronal axons from the colon and consequently a loss of motility. Constipation is a common symptom of irritable bowel syndrome.

The cure is simple: supplement. Specifically:

Selenium, 200 mcg/day (perhaps 400 mcg during a starting period). Selenium is needed for glutathione peroxidase, a glutathione recycling enzyme.
Vitamin C, 1 g/day (perhaps 4 g/day during a starting period). Vitamin C and glutathione recycle one another.
Zinc and copper. Total zinc intake should be 30-50 mg/day including food and multivitamin; copper intake should be 2-5 mg/day. Food typically provides 15 mg zinc and 1 mg copper.
Cysteine and glycine. These are the component amino acids for glutathione. For constipation I would suggest eating some beef gelatin for glycine, and taking one 500 mg capsule of N-acetylcysteine per day.

Egg yolks also increase glutathione production [3], and eating a dozen per week is highly recommended. Lipoic acid may also help. [4]

Glutamine, a supplement frequently recommended for gut ailments, can also enhance glutathione production [5]. However, I would generally avoid this, because it can promote proliferation of pathogenic bacteria.

Hypothyroidism

Hypothyroidism may be the most common cause of constipation.

A vicious circle often develops: Gut problems lead to autoimmune hypothyroidism, and constipation is only one symptom of the damage hypothyroidism does to the gut. The vicious circle can be broken by treating the hypothyroidism.

The cure:

Eliminate wheat, soy, and other autoimmune-promoting or goitrogenic toxins from the diet.
Supplement with thyroid supporting nutrients like:
- Selenium (as above).
- Magnesium (citrate or chelate) 200 mg/day.
- Zinc and copper (as above).
- Iodine.
Improve circadian rhythm. Circadian rhythm therapies for hypothyroidism were discussed in two posts, Intermittent Fasting as a Therapy for Hypothyroidism (Dec 1, 2010) and Seth Roberts and Circadian Therapy (Mar 22, 2011).
See your doctor to consider replacing thyroid hormone and investigating related problems. Your doctor can prescribe thyroid hormone and can explore related problems that may contribute to hypothyroidism, such as adrenal fatigue or iron deficiency.

As always, a few cautions about iodine supplementation. Before starting iodine, eliminate wheat from the diet and supplement with selenium, copper, and magnesium. If you have thyroid-related effects from copper supplementation, before proceeding further supplement copper until your thyroid no longer reacts. Start iodine at a low dose, say 500 mcg (0.5 mg) per day. Increase the iodine dose no faster than one doubling per month. When you increase the dose, if you have a reaction to the higher dose, phase it in: say, alternate between 0.5 mg and 1 mg for a week before trying 1 mg/day every day. Go slowly, plan on spending 4 months to reach 3 mg/day, which is a quarter Iodoral tablet. Tablets can be cut into pieces with razor blades and liquid solutions can be diluted; don’t hesitate to reduce doses.

Insufficient Dietary Fat and/or Bile

Not long ago Jamie Scott (That Paleo Guy), a very smart nutritional advisor, discussed his solution for constipation. There were several gems in there, for instance, that foods that stimulate opioid receptors can cause constipation [5b]:

For example, both gluten grains (and I suspect grains in general) plus dairy contain opiate-like compounds that serve to reduce the motility (movement) of your gut. This effect is commonly seen in those who have to take the likes of codeine (also an opiate) for any length of time.

Chocolate also has opioid peptides. But don’t worry, chocolate isn’t usually the cause of constipation!

But Jamie’s main advice was:

[M]any of the people I work with just are not eating enough fat….

People are a bit skeptical when I suggest increasing fat intake to overcome constipation. Thankfully I can now point to a clinical study in which a high fat diet, in very short time, increased gastrointestinal transit time, reducing the likelihood of constipation occurring;

Gastrointestinal transit, post-prandial lipaemia and satiety following 3 days high-fat diet in men

High-fat diets promote stool passage for several reasons.

Just a tiny bit of undigested fat can help grease the passage of stool through the colon. Even modest amounts of fat in the stool make it difficult to retain feces and cause fecal incontinence. This is why indigestible oils, like jojoba oil or Olestra, cause diarrhea.
A second factor is that bile is released into the intestine when fats are eaten, and bile acids have a laxative effect. Both the primary bile acid chenodeoxycholic acid (CDCA) and the secondary bile acid deoxycholic acid (DCA) act as laxatives by inducing water secretion in the colon. An excess of bile therefore causes diarrhea and an insufficiency can cause constipation. [6] This is why people who have had their gallbladders removed typically develop diarrhea: bile is constantly leaking into the digestive tract.

Just be sure that the high fat you eat comes from healthy natural sources, not high-omega-6 industrially processed seed oils.

Also, bile acid metabolism has a diurnal rhythm. [7] Improved bile acid metabolism may be another pathway by which circadian rhythm therapies could help constipation.

Insufficient Gut Flora

Fiber is often recommended for constipation, and though I believe insufficient fiber is rarely the primary factor in constipation, it can help by several mechanisms.

First, bacteria, dead and alive, form a large fraction of the stool, and the more fiber you eat, the more bacteria you will have. Bacteria are surrounded by fatty cell membranes which are a little bit slippery.

Second, and probably more important, gut bacteria tend to increase the laxative effect of bile.

This is because the body controls water secretion in the colon in part by sulfation of bile acids; sulfation eliminates the induction of water secretion.

Gut bacteria usually want more water in the colon than the body does, so they’ve evolved sulfatase enzymes that desulfate human bile acids. [8, 9] The desulfated bile causes water release and the stool becomes soft and loose.

Some bacterial species do this more than others – especially virulent strains that spread by inducing diarrhea – and I’m sure everyone’s experienced at some time in their lives what happens when one of these species overpopulates the gut. We often call this “food poisoning” and it can be treated by large doses of probiotics, to displace the bad species with bacteria that release fewer sulfatase enzymes.

At the opposite extreme, if gut bacteria are lacking then bile acids will be excessively sulfated and won’t induce water secretion. Constipation may develop.

Thus, antibiotics can induce constipation. Presumably a zero-carb, zero-fiber diet would also make constipation more likely.

Adding some fiber to your high-fat diet, therefore, can relieve constipation.

Choline

Even though choline deficiency is not a proven cause of constipation, I’ll put this in because choline is so important for health. Choline is needed to produce the neurotransmitter acetylcholine. A deficiency of acetylcholine is associated with loss of colonic motility and constipation. [10]

Egg yolks and liver are good sources of choline. There’s nothing wrong with choline supplementation either.

Hypercalcemia

Some people over-do vitamin D supplementation and/or calcium supplementation. Elevated blood calcium levels, which can be brought about by too much vitamin D, will cause constipation. If you supplement either vitamin D or calcium and have constipation, ask your doctor to check serum 25OHD, 1,25D, and calcium levels.

Gut Infections

Some pathogenic bacteria are able to paralyze the gut and induce constipation. Some bacterial species that induce diarrhea can also induce constipation when they choose – for instance, C. difficile. This is one reason why patients with bowel disorders such as Irritable Bowel Syndrome or ulcerative colitis often experience both constipation and diarrhea.

Antibiotics like vancomycin that work well against Clostridium have successfully reversed cases of constipation. [11]

Infection-induced constipation may also cause bloating, gas, acid reflux, and gastroparesis, so if your constipation is accompanied by these symptoms you should see a doctor.

Don’t over-use laxatives

It can be risky to over-use laxatives. The riskiest is probably senna, which promotes bowel movements by (a) inhibiting water absorption by the colon and (b) promoting muscle spasms in the colon wall. Unfortunately, senna is a toxin that can cause lasting damage, notably to nerves.

If you must use laxatives, magnesium citrate liquids are the best. This will restore your body’s magnesium status as well as promote clearing of the bowels.

Conclusion

With good diet and nutrition, and normalization of thyroid function, constipation is usually easily cured. The exceptional cases are those of chronic gut infections; these may require some detective work on the part of a doctor.

I’m sure this reads like a laundry list, but it should give those with constipation some ideas!

References

[1] Neal EG et al. The ketogenic diet for the treatment of childhood epilepsy: a randomised controlled trial. Lancet Neurol. 2008 Jun;7(6):500-6. http://pmid.us/18456557.

[2] Rao R. Oxidative stress-induced disruption of epithelial and endothelial tight junctions. Front Biosci. 2008 May 1;13:7210-26. http://pmid.us/18508729.

[3] Young D et al. Egg yolk peptides up-regulate glutathione synthesis and antioxidant enzyme activities in a porcine model of intestinal oxidative stress. J Agric Food Chem. 2010 Jul 14;58(13):7624-33. http://pmid.us/20540508.

[4] Chandrasekharan B et al. Colonic motor dysfunction in human diabetes is associated with enteric neuronal loss and increased oxidative stress. Neurogastroenterol Motil. 2011 Feb;23(2):131-8, e26. http://pmid.us/20939847.

[5] Cao Y et al. Glutamine enhances gut glutathione production. JPEN J Parenter Enteral Nutr. 1998 Jul-Aug;22(4):224-7. http://pmid.us/9661123.

[5b] Tuteja AK et al. Opioid-induced bowel disorders and narcotic bowel syndrome in patients with chronic non-cancer pain. Neurogastroenterol Motil. 2010 Apr;22(4):424-30, e96. http://pmid.us/20100280.

[6] Hofmann AF et al. Altered bile acid metabolism in childhood functional constipation: inactivation of secretory bile acids by sulfation in a subset of patients. J Pediatr Gastroenterol Nutr. 2008 Nov;47(5):598-606. http://pmid.us/18955863.

[7] Abrahamsson H et al. Altered bile acid metabolism in patients with constipation-predominant irritable bowel syndrome and functional constipation. Scand J Gastroenterol. 2008;43(12):1483-8. http://pmid.us/18788050.

[8] Huijghebaert SM, Eyssen HJ. Specificity of bile salt sulfatase activity from Clostridium sp. strains S1. Appl Environ Microbiol. 1982 Nov;44(5):1030-4. http://pmid.us/7181500.

[9] Ridlon JM et al. Bile salt biotransformations by human intestinal bacteria. J Lipid Res. 2006 Feb;47(2):241-59. http://pmid.us/16299351.

[10] Burleigh DE. Evidence for a functional cholinergic deficit in human colonic tissue resected for constipation. J Pharm Pharmacol. 1988 Jan;40(1):55-7. http://pmid.us/2896776.

[11] Celik AF et al. The effect of oral vancomycin on chronic idiopathic constipation. Aliment Pharmacol Ther. 1995 Feb;9(1):63-8. http://pmid.us/7766746.

Creamy Steamed Egg Soup

Posted by Paul Jaminet on April 3, 2011 9 comments

This is a sort of hybrid of an omelette, the steamed egg custards which are popular in Asia, and a soup.

It is a good for busy families because:

(a) it is quick and easy to make;

(b) it can be eaten at any meal – breakfast, lunch, or dinner; and

(c) it can satisfy a diversity of tastes, since each family member can choose a personal set of ingredients and cook the meal in his own bowl.

Ingredients

Here’s a sample set of ingredients: eggs, cream, and bone broth (for a great broth, get bones with as much fat and collagen attached as you can!); scallions, tomatoes, and shrimp.

The volume of the cream and broth should be equal to the volume of the eggs. Water or milk can be substituted for broth if it is unavailable. Other ingredients we frequently use are shiitake mushrooms, onions, smoked gouda or pecorino romano cheese, bell peppers, bacon, meats, and fish. Not shown are herbs and spices to taste.

Start by mixing the eggs, cream, and bone broth:

Pour these into a bowl through a strainer. This breaks the egg white up into tiny pieces, mixing it into the fat and broth and preventing chunks of uncooked protein from appearing in the soup.

Then, mix in the other ingredients and spices to taste:

While you’re doing that, start a little water boiling in a wok:

You’ll need a steaming tray to put in the wok; this elevates the bowls above the boiling water.

If you have a large pot with a steaming basket, that will work equally well. We used the wok because it has a glass cover and we can take pictures as it cooks.

It comes out looking like this:

And here it is served:

You want to cook just long enough – 5 to 10 minutes depending on the size of the bowl – so that protein is cooked.

We’ve tried cooking this in the microwave, but it doesn’t taste as good: the egg comes out tougher.

Buffet-style family dinners

If not everyone has the same taste in food, set out ingredients buffet-style and let them build their own meal. Here are a few alternative ingredients:

Our wok fits three soup bowls:

This is what the finished product looks like:

Individual bowls take about 5 minutes to cook, one large bowl about 10 minutes.

Accompaniments

For complete macronutrients in one meal, potatoes or sweet potatoes with butter or sour cream, or rice with seasoned seaweed, and vegetables such as kimchi can be served alongside. We buy kimchi at an Asian supermarket on weekends and it relieves us from having to make vegetables during the week.

Conclusion

Steamed egg custards are very popular in China, Japan, and Korea, but they are generally made without cream or broth – just eggs, water, and salt. This particular version is our own invention, and we think the bone broth, the cream, and the delicate texture of the steamed egg make a delightful combination.

Around the Web, Evil Vegan Plot Edition

Posted by Paul Jaminet on April 2, 2011 33 comments

(My apologies: I have been busy with work and the post on constipation I had planned for Thursday will appear Monday.)

Here are items that caught my eye this week:

[1] Interesting posts this week: Dr. Steve Parker offers a history of the Mediterranean Diet. Did you know that Ancel Keys invented it? Frank Hagan of Low Carb Age reminds us of the dangers of giving too much protein to children – a topic I expect to blog about again soon. The New York Times explains what video of slipping birds teaches us about running form. Mary Shomon lists the 10 Mistakes of Thyroid Doctors. Kevin Brown of Liberation Wellness argues that doctors may be the leading cause of death. Andrew Badenoch of evolvify assembles evidence that gluten is harmful to non-celiacs. J. Stanton of gnolls.org explains why snacking makes you weak.

[2] Low-Carb for Fatty Liver Disease: An oldie but goodie from Michael Eades: Four patients with extremely high triglycerides due to fatty liver were cured in days on a low-carb diet. Yet another condition that is impossible to cure by drugs, trivial to cure by diet.

[3] Is Fruit Paleo?: Melissa McEwen notes what wasn’t on the Paleolithic menu: fruit.

I might add that it’s not clear that fruit was ever a major part of our ancestors’ diet. The ancestors of chimpanzees and gorillas may have been begun eating fruit after their divergence from the “chuman” human-chimp-gorilla common ancestor. Human ancestors may never have lived in the forests, where fruit is available.

What might Paleolithic Europeans have eaten instead? Melissa casts a vote for raw liver.

[4] What happens if you skip the liver?: On Tuesday morning, Shou-Ching asked me to highlight the story about the French vegans whose breast-fed baby died of pneumonia caused by malnourishment. The baby was severely deficient in vitamins A and B12.

A few hours later Richard Nikoley blogged the story. Vegans, head over there for some sense.

It is possible to be a healthy vegetarian – our book has an appendix explaining how to do it – but it helps immensely to include eggs, dairy, and nutritional supplements. To exclude all animal-related foods, and not to supplement key animal-derived nutrients, is slow suicide – sometimes, as the French story shows, quick infanticide.

[5] 30 Bananas a Day not immediately fatal: Thanks to Richard’s post I looked at a video of a 30 Bananas a Day retreat. I was pleased to see them drinking coconut milk (healthy saturated fats) and, on sandwiches, replacing bread with melon slices. A zero-grain saturated-fat-rich diet – it might be malnourishing, but at least it’s low-toxicity:

You know it can’t be all bad if Stephan has converted!

[6] The French resistance lives: The Guardian:

[I]t is not easy being vegetarian in France, the land of steak-frites, foie gras and other solidly carnivorous fare…. A non-scientific survey of Facebook reveals that the British-based Vegan society has 60,978 fans, while the French Vegetarian Association has 1,518 and the Vegetarian and Vegan page 1,173. (By comparison the French “Slap a Vegetarian with an Escalope” page has 168,294 fans.)

Maybe we should take a trip to Paris, to check out the food. It sounds good!

[7] Insulin Wars!: O Primitivo gives this name to the dust-up that started with CarbSane assailing Gary Taubes and picked up recently at Peter’s blog. He offers an amusing cartoon:

As it happens Shou-Ching and I went to hear Gary Taubes talk on “Why We Get Fat” last Wednesday, and I may review it this week. Those who would like to hear a nearly identical talk can go to Gary’s site and view the “IMS Online Lecture” on YouTube.

[8] Good News From Japan: A dog was rescued:

[9] Bad News From Alabama and Malaysia: From an Alabama teacher:

I am a 6th grade school teacher, and I am appalled at what we are feeding our children every day in the lunchroom. Yesterday our students had pizza, corn, wheat bread, and rice krispie treats. They could also buy slushies full of sugar and food coloring. Also available was tea sweetened with splenda. It is unbelievable that people with degrees in nutrition are planning these meals! It is no wonder that we have such a problem with childhood obesity and that our schools are full of students that have ADHD, behavior problems, and learning problems.

From another reader:

In Malaysia (Sarawak), I was served a local dessert made with Sago and coconut milk and sugar. Wonderful! I asked about the sago and was told it was a starch made from trees! The next day for lunch I had the sago (in hardened form) with some type of local fish marinated in spicy oil. I asked if they eat the sago often and sadly I heard this story: Sago is a local food that they have made and eaten for centuries BUT now everyone in Malaysia realizes that coconut oil and coconut milk have saturated fat so they should not eat it very often and because the sago is primarily associated with these ‘fattening’ and ‘bad for you’ foods, that the sago is going out of style. Truly sad.

Sago is, of course, one of the safe starches recommended in our book; and you know we like coconut oil and coconut milk.

C.H. Spurgeon said that a lie can get around the world before the truth gets its boots on. A lie has conquered Alabama schools and reached Malaysia. Does the truth have its boots on yet?

[10] Candy eating good?: Epidemiology is hard to interpret, but this was interesting. Compared to adults who ate no candy, candy-eaters had lower body weight, 5% slimmer waists, lower blood pressure, and higher HDL – despite eating more total calories and more saturated fat.

I doubt this is supporting evidence for 30 bananas a day. Two more plausible explanations:

Adults who eat candy pay no attention to the health advice propagated by authorities, and follow their taste buds (which evolved to help them) toward meats and fats and away from grains.
When adults develop poor health, they start avoiding candy.

Nevertheless, if I do review Gary Taubes this week, this paper might deserve a mention. It counts against both the “carbs make you fat” and the “gluttony makes you fat” theories!

Source: O’Neil CE et al. Candy consumption was not associated with body weight measures, risk factors for cardiovascular disease, or metabolic syndrome in US adults: NHANES 1999-2004. Nutr Res. 2011 Feb;31(2):122-30. http://pmid.us/21419316.

(Via John J. Ray, Food & Health Skeptic.)

[11] Addendum to last week: Speaking of John J. Ray, he has a nice cartoon that I wish I’d used in last Saturday’s #11 on increasing morbidity among the elderly:

[12] Second addendum to last week: I noted last Saturday (#8) a study claiming that “displays of power” led to increased testosterone with positive health effects.

But can displaying a “We Rule” t-shirt transform milquetoast economists into dominant athletes? They actually studied this question at Stanford:

(Via John B Taylor)

[13] Aerobic Exercise Not as Healthy as Candy: Fight Aging! notes that while lower metabolic rates extend lifespan, aerobic exercise doesn’t lower metabolic rate (despite lowering pulse rates). Moreover, higher 24-hour energy expenditure shortens lifespan – so “chronic cardio” may shorten lifespan! It may not be a coincidence that centenarians rarely exercise intensely. They are active but rarely fitness freaks.

One topic I’ve gotten a bit interested in is the effect of obesity on lifespan, which is not large. If obesity induces a lifelong reduction in metabolic rate, it may tend to extend lifespan even as it impairs health. Perhaps this has something to do with the fact that obesity rates are rising and lifespan is lengthening even as morbidity is increasing.

[14] Evil Plot Uncovered: For weeks Richard Nikoley has been claiming to have evil plots underway. I love an evil plot, so I investigated. I haven’t felt as cheated since I flew business class to Tokyo booked as a vegan, and had to eat seaweed while everyone else got filet mignon.

Turns out his evil plots were to inspire vigorous discussion in his comment section and improve the health of young children.

At first I thought I had been duped: Clark Kent was pretending to be Lex Luthor, and I got suckered. But then I realized it was rather like the Cretan Paradox. If only the evil lie, and he had lied, then he must be evil. And evildoers plot. So he really must have an evil plot – even though he said he did, which would make him honest – unless he had lied about the nature of his plot. But what could his real evil plot be?

It so happened I recently installed a Firefox add-on that displays site meta tags. What do you think is high on Richard’s list? Not the first tag – his reachout to the porn community (“food porn”). This: “vegan / vegetarian.”

This can only mean one thing. Richard Nikoley is attempting a hostile takeover of the vegan community. He’s trying to replace T. Colin Campbell as their leader. His upcoming book? The New Evolutionary Vegan Diet Solution. Its premise: vegans are so brain-addled from lack of B12, they won’t notice their new diet is 90% beef.

Yes, I know he won’t admit it. No evil plotter ever admits his plans. Just remember – when it happens, you heard it here first.

[15] Hot pinup girl!: Yes, inspired by Richard’s “porn” tag I’m trolling for Google hits: