Right then...

Here's all kinds of news:

My Dad -

On Sunday we went down to Chichester to see him. As we walked around the door into the ward he was standing up helping some other patient to get their television working! Can you believe it. 2 weeks ago we thought he was going to die, and now he is back being his normal helpful self!

He is painfully thin and grey looking, very weak of voice and a little bit doddery on the ole' pegs, but its my Dad again rather than the hot, puffed up slightly jaundiced unconscious lump that he was 2 weeks ago. He looks old though. As soon as he gets back from hospital I am sure he will gain all the weight again and fill out his gaunt face and stuff. Its amazing what 3 weeks being fed by a tube can do to you - an option I have not yet explored HA HA.

So for all of you who have been so supportive, and keeping my spirits up, things are definitely looking better now.

It looks like he will be coming home possibly the end of the week, but we don't want to push it. If they don't suggest it again, then we wont ask. Its better to make sure he is totally fine before being released into the world again. He will be coming home with a portable VAC machine which is what is being used to close his wounds. They are not sewing him up because a lot of necrotic tissue was removed and so he has to grow some new skin to close the wound himself. Its an amazing machine.

If you are squeamish, then don't read any more..

Step 1
The foam dressing is cut to the approximate size of the wound with scissors and placed gently into position

Step 2
The perforated drain tube is then located on top of the foam and a second piece of foam placed over the top. For shallower wounds, a single piece of foam may be used and the drainage tube is inserted inside it.

Step 3
The foam, together with the first few inches of the drainage tube and the surrounding area of healthy skin, is then covered with the adhesive transparent membrane supplied. At this stage it is important to ensure that the membrane forms a good seal both with the skin and the drainage tube.

Step 4
The distal end of the drain is connected to the VAC unit, which is programmed to produce the required level of pressure.


Step 5
Once the vacuum is switched on, the air is sucked out of the foam causing it to collapse inwards drawing the edges of the wound in with it.

Step 6
Fluid within the wound is taken up by the foam and transported into the disposable container within the main vacuum unit.

My Dads wound is obviously a LOT bigger than this. These sponge things come in all kinds of sizes which is great and as the 'juices' from the wound that make scabs and new skin are sucked from the bottom to the surface the skin gets a fresh supply of this wonder serum which basically grows you a new tummy! Amazing, and all natural basically.

He is now only on Paracetamol regularly, and in no pain at all.

KITTENS:

We have 6 beautiful kittens and they are all so gorgeous and all of them have already been sold can you believe!

This is the most beautiful photo of 'BOB' as named by his new owners.

I will add a photo of each one this time so that I can remember them forever. I wont be keeping any of this litter which is a real shame as they are so amazingly cute!

Onto the band... well I am going to put a post about that later on today. Just to whet your appetite, I am strangely worried about it all...

Paleolithic Diet Clinical Trials Part II

There were a number of remarkable changes in both trials. I'll focus mostly on Dr. Lindeberg's trial because it was longer and better designed. The first thing I noticed is that caloric intake dropped dramatically in both trials, -36% in the first trial and a large but undetermined amount in Dr Lindeberg's. The Mediterranean diet group ended up eating 1,795 calories per day, while the paleolithic dieters ate 1,344. In both studies, participants were allowed to eat as much as they wanted, so those reductions were purely voluntary.

This again agrees with the theory that certain grains (wheat) promote hyperphagia, or excessive eating. It's the same thing you see in low-carbohydrate diet trials, such as this one, which also reduce grain intake. The participants in Lindeberg's study were borderline obese. When you're overweight and your body resets its fat mass set-point due to an improved diet, fatty acids come pouring out of fat tissue and you don't need as many calories to feel satisfied. Your diet is supplemented by generous quantities of lard. Your brain decreases your calorie intake until you approach your new set-point.

That's what I believe happened here. The paleolithic group supplemented their diet with 3.9 kg of their own rump fat over the course of 12 weeks, coming out to 30,000 additional calories, or 357 calories a day. Not quite so spartan when you think about it like that.

The most remarkable thing about Lindeberg's trial was the fact that the 14 people in the paleolithic group, 2 of which had moderately elevated fasting blood glucose and 10 of which had diabetic fasting glucose, all ended up with normal fasting glucose after 12 weeks. That is truly amazing. The mediterranean diet worked also, but only in half as many participants.

If you look at their glucose tolerance by an oral glocose tolerance test (OGTT), the paleolithic diet group improved dramatically. Their rise in blood sugar after the OGTT (fasting BG subtracted out) was 76% less at 2 hours. If you look at the graph, they were basically back to fasting glucose levels at 2 hours, whereas before the trial they had only dropped slightly from the peak at that timepoint. The mediterranean diet group saw no significant improvement in fasting blood glucose or the OGTT. Lindeberg is pretty modest about this finding, but he essentially cured type II diabetes and glucose intolerance in 100% of the paleolithic group.

Fasting insulin, the insulin response to the OGTT and insulin sensitivity improved in the paleolithic diet whereas only insulin sensitivity improved significantly in the Mediterranean diet. Fasting insulin didn't decrease as much as I would have thought, only 16% in the paleolithic group.

Another interesting thing is that the paleolithic group lost more belly fat than the Mediterranean group, as judged by waist circumference. This is the most dangerous type of fat, which is associated with, and contributes to, insulin resistance and the metabolic syndrome. Guess what food belly fat was associated with when they analyzed the data? The strongest association was with grain consumption (probably mostly wheat), and the association remained even after adjusting for carbohydrate intake. In other words, the carbohydrate content of grains does not explain their association with belly fat because "paleo carbs" didn't associate with it. The effect of the paleolithic diet on glucose tolerance was also not related to carbohydrate intake.

So in summary, the "Mediterranean diet" may be healthier than a typical Swedish diet, while a diet loosely modeled after a paleolithic diet kicks both of their butts around the block. My opinion is that it's probably due to eliminating wheat, substantially reducing refined vegetable oils and dumping the processed junk in favor of real, whole foods. Here's a zinger from the end of the paper that sums it up nicely (emphasis mine):

The larger improvement of glucose tolerance in the Paleolithic group was independent of energy intake and macronutrient composition, which suggests that avoiding Western foods is more important than counting calories, fat, carbohydrate or protein. The study adds to the notion that healthy diets based on whole-grain cereals and low-fat dairy products are only the second best choice in the prevention and treatment of type 2 diabetes.

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.