Awful/Great = Hmmm

I am feeling really odd. I feel terrible about my weight, but Great about the new possibilities.

I went to WLS clinic on Sunday en-route to the hospital where my Dad is.

I weighed in at 16 stone 8 pounds. That's just gruesome, but basically I have put on a stone since my un-fill. It could have been a hell of a lot worse!

I told her all about how I was feeling - very unrestricted, hungry etc. I told her how I had committed to my weight loss again by ordering a months supply of food from Diet Chef. They provide you with breakfast, lunch, snack and dinner of wholesome low Gi food for £190 a month. Its not necessary to keep it in the fridge or freezer - you just store it in the cupboard and it should be 1200 cals a day if you stick to it. It turns out its actually 1000 cals a day, but they allow you some fresh fruit and veg to bulk it all up.

I told her how I thought that I needed a big whack this time because I had not noticed any difference after any of my subsequent fill and that frankly I am running out of cash (not just for the fills, but for petrol to poxy London and back and the week off work recuperation!)

She has given me 0.7mls this time. this takes me to 7mls total in my band which is half a ml more than I had in there before she removed 1ml on August 10th. So it really seems like it was Malta that messed my restriction up. It just got so aggravated that it was a vicious cycle.

Anyway, so far so good. I never do that whole liquids thing because I just can't face it, and I want to know quickly whether or not I have restriction. Well, when I compare how I felt on my new Diet Chef meals on Friday and Saturday to how I felt yesterday and today, there is a big difference. I am FULL! I was literally starving hungry on the other days, but I haven't had a single hunger pang today.

So hopefully everything will start to get back on track.

Hmmm

Paleolithic Diet Clinical Trials

If Dr. Ancel Keys (of diet-heart hypothesis fame) had been a proponent of "paleolithic nutrition", we would have numerous large intervention trials by now either confirming or denying its ability to prevent health problems. In this alternate reality, public health would probably be a lot better than it is today. Sadly, we have to settle for our current reality where the paleolithic diet has only been evaluated in two small trials, and medical research spends its (our) money repeatedly conducting failed attempts to link saturated fat to every ill you can think of. But let's at least take a look at what we have.

Both trials were conducted in Sweden. In the first one, lead by Dr. Per Wändell, 14 healthy participants (5 men, 9 women) completed a 3-week dietary intervention in which they were counseled to eat a "paleolithic diet". Calories were not restricted, only food categories were. Participants were told to eat as much as they wanted of fruit, vegetables, fish, lean meats, nuts, flax and canola oil, coffe and tea (without dairy). They were allowed restricted quantities of dried fruit, potatoes (2 medium/day) salted meat and fish, fat meat and honey. They were told not to eat dairy, grain products, canned food, sugar and salt.

After three weeks, the participants had:

• Decreased their caloric intake from 2,478 to 1,584 kcal
• Increased their percentage protein and fat, while decreasing carbohydrate
• Decreased saturated fat, increased dietary cholesterol, decreased sodium intake, increased potassium
  
• Lost 2.3 kg (5 lb)
• Decreased waist circumference, blood pressure and PAI-1

Not bad for a 3-week intervention on healthy subjects. This study suffered from some serious problems, however. #1 is the lack of a control group as a means for comparison. Ouch. #2 is the small study size and resulting lack of statistical power. I consider this one encouraging but by no means conclusive.

The second study was conducted by the author of the Kitava study, Dr. Staffan Lindeberg. The study design was very interesting. He randomly assigned 29 men with ischemic heart disease, plus type II diabetes or glucose intolerance, to either a "Mediterranean diet" or a "paleolithic diet". Neither diet was calorie-restricted. Here's the beauty of the study design: the Mediterranean diet was the control for the paleo diet. The reason that's so great is it completely eliminates the placebo effect. Both groups were told they were being assigned to a healthy diet to try to improve their health. Each group was educated on the health benefits of their diet but not the other one. It would have been nice to see a regular non-intervention control group as well, but this design was adequate to see some differences.

Participants eating the Mediterranean diet were counseled to focus on whole grains, low-fat dairy, potatoes, legumes, vegetables, fruit, fatty fish and vegetable oils rich in monounsaturated fats and alpha-linolenic acid (omega-3). I'm going to go on a little tangent here. This is truly a bizarre concept of what people eat in the Mediterranean region. It's a fantasy invented in the US to justify the mainstream concept of a healthy diet. My father is French and I spent many summers with my family in southern France. They ate white bread, full-fat dairy at every meal, legumes only if they were smothered in fatty pork, sausages and lamb chops. In fact, full-fat dairy wasn't fat enough sometimes. Many of the yogurts and cheeses we ate were made from milk with extra cream added. Want to get a lecture from Grandmere? Try cutting the fat off your pork chop!

The paleolithic group was counseled to eat lean meat, fish, fruit, leafy and cruciferous vegetables, root vegetables (including moderate amounts of potatoes), eggs and nuts. They were told to avoid dairy, grain products, processed food, sugar and beer.

Both groups were bordering on obese at the beginning of the study. All participants had cardiovascular disease and moderate to severe glucose intolerance (i.e. type II diabetes). After 12 weeks, both groups improved on several parameters. That includes fat mass and waist circumference. But the paleolithic diet trumped the Mediterranean diet in many ways:

• Greater fat loss in the the midsection and a trend toward greater weight loss
  
• Greater voluntary reduction in caloric intake (total intake paleo= 1,344 kcal; Med= 1,795)
  
• A remarkable improvement in glucose tolerance that did not occur significantly in the Mediterranean group
• A decrease in fasting glucose
  
• An increase in insulin sensitivity (HOMA-IR)
  

Overall, the paleolithic diet came out looking very good. But I haven't even gotten to the best part yet. At the beginning of the trial, 12 out of the 14 people in the paleo group had elevated fasting glucose. At the end, every single one had normal fasting glucose. In the Mediterranean group, 13 out of 15 began with elevated glucose and 8 out of 15 ended with it. This clearly shows that a paleolithic diet is an excellent way to restore glucose control to a person who still has beta cells in their pancreas.

This post is getting long, so I think I'll save the interpretation for the next post.

Acne Anecdotes

Thanks for all the interesting comments on the last post. Here are some highlights:

Methuselah:

I had bad acne as a teenager and although the worst of it did clear up for as I got older (this seems to be the pattern, so presumably there are hormones other than insulin involved,) I still had spotty skin into my 20s and 30s. When I went onto a Paleo diet my skin cleared up totally.

Neil:

I am lucky enough to have reasonable skin already, but reducing carbs and vegetable oils has at the least coincided with a notable improvement

Jeff:

I used to get... 2-3 pimples most months. Since I have gone Paleo I have had not a single pimple in 8 months.

Itsthewoo:

I had terrible acne that lasted from 9 yrs right up until 20 years - the same week I started the atkins diet. Then it stopped.

I see the skin as a barometer of health. A truly healthy person's skin is smooth, free of acne and has a gentle blush in the cheeks. Unhealthy skin is pale, puffy, pasty, dry, oily, or excessively red in the cheeks and face. It's no coincidence that what we perceive as attractive also happens to indicate health.

I'll add one more anecdote, from myself. In high school, my friends called me "the ghost" because my skin was so pale. I had mild but persistent acne and difficulty tanning. Over the past few years, as I've improved my diet, my skin has smoothed, I've regained the color in my cheeks, I've regained my ability to tan well and my acne has disappeared.

Mrs.Dash Baked Chicken Siciliano

Hello Neighbors!I am a big fan of Mrs. Dash seasoning blends because they are no-salt, no-MSG and they are tasty! The Mrs.Dash website has some terrific recipes and ideas for using the seasoning blends to punch-up ordinary meals. This recipe for Baked Chicken Siciliano comes from there and it is quick and delicious. Give it a try! For you 5 Day Pouch Testers this week save it for Day 5 or Day 6

Losing Weight After Age 45

Pamela has lost 13 inches from her waist. She's down to 118 pounds, from a high of 215 in July of 2007. She lost the weight by changing her diet and doing pool exercises.

See her inspiring story and two other midlife weight loss stories at the Palm Beach Post.

Acne: Disease of Civilization

I often focus on the bigger facets of the disease of civilization. Things like cardiovascular disease and cancer, which are major killers and the subject of intensive research. But the disease of civilization is a spectrum of disorders that affects the body in countless ways, large and small.

I recently read an interesting paper written by an all-star cast, including Loren Cordain, Staffan Lindeberg and Boyd Eaton. It's titled "Acne Vulgaris: A Disease of Western Civilization". The paper presents data from two different groups, the Kitavans of Papua New Guinea and the Ache hunter-gatherers of Paraguay. Both were systematically examined by doctors trained to diagnose acne. Out of 1,200 Kitavans and 115 Ache of all ages, not a single case of acne was observed. Hunter-gatherers and other healthy non-industrial cultures have nice skin. I dare you to find a pimple in Nutrition and Physical Degeneration.

In Western societies, acne is a fact of life. The paper states that 79 to 95% of modern adolescents suffer from some degree of acne, along with about 50% of young adults. That's an enormous difference.

The paper presents a very Cordain-esque hypothesis to explain the high incidence of acne in Western societies. In sum, they state that the Western diet causes hyperinsulinemia, which is thought to promote acne. This is due to insulin's effects on skin cell proliferation, its interference with the retinoid (vitamin A) signaling pathway, and its effect on sebum production.

They then proceed to point the finger at the glycemic index/load of the Western diet as the culprit behind hyperinsulinemia. It's an unsatisfying explanation because the Kitavans eat a diet that has a high glycemic load due to its high carbohydrate content, low fat content, and relatively high-glycemic index foods. I think the answer is more likely to reside in the specific types of carbohydrate (processed wheat) rather than their speed of digestion, with possible contributions from refined vegetable oil and an excessive sugar intake.

Not bad

Ok, so I didnt wake up with £millions in the bank or a fine physique... yet anyway.

However, I am feeling * Not Bad *

This morning I went and got DS from Lotse and Csilla's where he had stayed for the weekend so we could do the hospital runs. Being Hungarian they are not too up to speed with the whole English education system of GCSE's, A Levels and NVQ's etc... so I spent an hour or so going over Their daughter Lili's possible education routes, had a coffee and come back home.
When I got home and it was about 12, and took a call from Mum saying that Dad was being moved to a 'normal' ward. I am in two minds about this. Its obviously good news because he is getting much better, but there again, the nurses swan around in their outdoor clothes and the cleanliness leaves a lot to be desired and its where he has picked up the previous 2 infections right? So its a bit of a catch 22.

Anyway, enough about all that rubbish, I am fed up with talking about it.

For lunch today I had home made carrot soup. In it was just carrot and onions and a bit of coriander, salt and pepper. I had 3lbs of carrots to use up, so made a whole cauldron of it last week. I also had a boiled egg with it too.

For a snack this afternoon I had an egg.

This evenings dinner is roast chicken (not for me!) and Broccoli, Romanesco, and cauliflower and potato and gravy. That's it. So I am being good.

I have also booked a fill for Sunday. Go me!