Celiac and Fat-Soluble Vitamins

One of the things I've been thinking about lately is the possibility that intestinal damage due to gluten grains (primarily wheat) contributes to the diseases of civilization by inhibiting the absorption of fat-soluble vitamins. If it were a contributing factor, we would expect to see a higher incidence of the common chronic diseases in newly-diagnosed celiac patients, who are often deficient in fat-soluble vitamins. We might also see a resolution of chronic disease in celiac patients who have been adhering faithfully to a long-term, gluten-free diet.

One thing that definitely associates with celiac disease is bone and tooth problems. Celiac patients often present with osteoporosis, osteopenia (thin bones), cavities or tooth enamel abnormalities (thanks Peter).

An Italian study showed that among 642 heart transplant candidates, 1.9% had anti-endomyosal antibodies (a feature of celiac), compared with 0.35% of controls. That's more than a 5-fold enrichment! The majority of those patients were presumably unaware of their celiac disease, so they were not eating a gluten-free diet.

Interestingly, celiac doesn't seem to cause obesity; to the contrary. That's one facet of modern health problems that it definitely does not cause.

The relationship between cancer and celiac disease is very interesting. The largest study I came across was conducted in Sweden using retrospective data from 12,000 celiac patients. They found that adult celiac patients have a higher overall risk of cancer, but that the extra risk disappears with age. The drop in cancer incidence may reflect dropping gluten following a celiac diagnosis. Here's another study showing that the elevated cancer risk occurs mostly in the first year after diagnosis, suggesting that eliminating gluten solves the problem. Interestingly, celiac patients have a greatly elevated risk of lymphoma, but a lower risk of breast cancer.

There's a very strong link between celiac and type I diabetes. In a large study, 1 in 8 type I diabetic children had celiac disease. This doesn't necessarily tell us much since celiac and type I diabetes are both autoimmune disorders.

One last study to add a nail to the coffin. Up to this point, all the studies I've mentioned have been purely observational, not able to establish a causal relationship. I came across a small study recently which examined the effect of a high-fiber diet on vitamin D metabolism in healthy (presumably non-celiac) adults. They broke the cohort up into two groups, and fed one group 20g of bran in addition to their normal diet. The other group got nothing extra. The bran-fed group had a vitamin D elimination half-life of 19.5 days, compared to 27.5 for the control group. In other words, for whatever reason, the group eating extra bran was burning through their vitamin D reserves 30% faster than the control group.

Unfortunately, the paper doesn't say what kind of bran it was, but it was probably wheat or oat (**Update- it's wheat bran**). This is important because it would determine if gluten was involved. Either way, it shows that something in grains can interfere with fat-soluble vitamin status, which is consistent with the staggering negative effect of wheat products on healthy non-industrialized cultures.

Add to this the possibility that most people may have some degree of gluten sensitivity, and you start to see a big problem. All together, the data are consistent with gluten grains interfering with fat-soluble vitamin status. As I discussed earlier, this could strongly contribute to the diseases of civilization. These data don't prove anything conclusively, but I do find them thought-provoking.

Thanks to Dudua for the CC photo

Had 3 meals today!

For breakfast I had half a pancake.

For lunch I had some Hungarian 'Gnoccedly' and 'Perkerd'. Y U M! I have absolutely NO idea how to spell these, so they are phonetic versions of what we were served up. Gnoccedly is a kind of homemade pasta put through a utensil that looks like a blunt cheese grater straight into boiling water. The result is a kind of pasta that looks like mini cumulus clouds... like the italian Gnocci but smaller and very tasty. This is then covered in this stuff called 'Perkerd'. Its chicken drumsticks cooked in an onion puree with pepper and paprika, tomato and sour cream sauce. Its wonderful. I managed a bowl of the pasta and a little of the sauce on it. I didn't even bother with the chicken.

For dinner I had a full Sunday Roast. 1 sprig of broccoli, 1 spoon carrots, 1/2 slice beef, 1/2 roast potato and a Yorkshire pudding smothered in gravy and horseradish served up on a tea plate. It was delish!

Two Things That Get on My Nerves, Part II

Confusing Correlation and Causation

Recently, a paper was published that examined the association between sleep duration and the risk of death. Ferrie et al. showed that in their study population, subjects who slept either more or less than 7 hours a night had an increased overall risk of death. Here's how it was reported in Medical News Today:

Too Little Or Too Much Sleep Increases Risk Of Death

And here's a gem of a quote from one of the study's authors (excerpt from the article above):

In terms of prevention, our findings indicate that consistently sleeping around 7 hours per night is optimal for health and a sustained reduction may predispose to ill-health.

There's only one small problem: the study indicated no such thing. What the study showed is that people who sleep more or less than 7 hours tend to die more often than people who don't, not that the lack or excess of sleep caused the increased mortality. Have you ever noticed that you sleep more when you're not feeling well? Have you ever noticed that you sleep less when you're stressed? Could the increased mortality and sleep disturbances both be caused by some other factor(s), rather than one causing the other? We don't know, because the nature of the study doesn't allow us to answer that question!

The message the public ends up hearing is that no matter what feels right for your body, 7 hours of sleep is the optimum for health. Even though you'll have to go to work with bags under your eyes, feeling like crap, it's healthy. Even though you have the flu, you'd better not sleep more because it might give you a heart attack. That paper is just another example of perfectly good data being misinterpreted, and leading to an absurd conclusion.

The only way we could say that 7 hours of sleep is the healthiest amount (for the "average" person), would be to do an "intervention study", in which the subjects are manipulated rather than simply observed. Here's how it would work: we would take a large group of people and randomly assign them to either 5, 7 or 9 hours of sleep a night. We would then look at mortality over the course of the next few years, and see who dies more.

Intervention studies are the only way to establish causality, rather than simple association! At the end of our study, we could rightfully say that X amount of sleep causes an increase or decrease in mortality. Obviously, these types of studies are challenging and expensive to conduct, so it's tempting to over-interpret epidemiological studies like the one I mentioned initially.

This has to be one of the gravest, most frequent mistakes in the realm of health research and reporting. So many of the health recommendations we get from the media, the government, and even so-called scientists are entirely based on associations! Things like fiber is healthy and saturated fat is unhealthy. Those are conclusions that were drawn from studies that could only determine associations, yet neither has been consistently supported by intervention trials!

Misinterpreted data is worse than no data at all. Just say no to bad science!

Two Things that Get on My Nerves, Part I

The "Thrifty Gene" Hypothesis

The thrifty gene hypothesis is the darling of many obesity researchers. It was proposed in 1962 by the geneticist James V. Neel to explain the high rates of obesity in modern populations, particularly modernizing American Indians. It states that our species evolved under conditions of frequent starvation, so we're designed to store every available calorie. In today's world of food abundance, our bodies continue to be thrifty and that's why we're fat.

Obesity researchers love it because it dovetails nicely with the equally dim "calories-in, calories-out hypothesis", whereby calories alone determine body composition. You practically can't read a paper on overweight without seeing an obligatory nod to the thrifty gene hypothesis. The only problem is, it's wrong.

The assumption that hunter-gatherers and non-industrial agriculturalists lived under chronic calorie deprivation has been proven false. The anthropological evidence indicates that most hunter-gatherers had abundant food, most of the time. They did have fluctuations in energy balance, but the majority of the time they had access to more calories than they needed, just like us. Yet they were not fat.

The Kitavans are a good example. They are an agricultural society that eats virtually no grains or processed food. In Dr. Staffan Lindeberg's studies, he has determined that overweight is virtually nonexistent among them, despite an abundant food supply.

The cause of obesity is not the availability of excess calories, it's the deregulation of the bodyweight homeostasis system. We have a very sophisticated set of feedback loops that "try" to maintain a healthy weight. It's composed of hormones (insulin, leptin, etc.), certain brain regions, and many other elements, known and unknown. These feedback loops influence what the body does with calories, as well as feeding behaviors. When you throw a wrench in the gears with a lifestyle that is unnatural to the human metabolism, you deregulate the system so that it no longer maintains an appropriate "set-point".

Here's what Neel had to say about his own theory in 1982 (excerpts from Good Calories, Bad Calories):

The data on which that (rather soft) hypothesis was based has now largely collapsed.

And what does he think causes overweight in American Indians now?

The composition of the diet, and more specifically the use of highly refined carbohydrates.

RIP, thrifty gene.


For more information on bodyweight regulation, see:

Insulin Controls Your Fat
Leptin and Lectins
Thoughts on Obesity Part I
Thoughts on Obesity Part II
Body Composition

Wow, how tight am I?

Rather a loaded title, but you guys know what I mean!

had a couple of depressing food days.
Where are we... Thursday? Ok... well I will start with Tuesday then. It was really random and I must admit that I had a few thoughts about band slippage because it was so weird...

I don't think I ate anything all morning, and at lunch I had a couple of salami slices and half a slice of bread and butter. At about 3:30 I went off to work, and I was feeling mighty dodgy. I was sick at my pupils house... this was induced sickness rather than spontaneous. I am going to have to invent some word for this. Its not a pb. I hate that phrase too. I don't get pb's in the true sense of what they mean - productive burps. I get an elephant standing on my chest and have to induce vomiting. Then I feel better.

Ok... I am gonna call it HMS - as in Had to Make myself Sick

So, I HMS, and came home feeling a bit woozy. I really needed sugar ad I had that whole tremor thing going on. So I bought chocolate. 3 bars for £1 (bargain). Ate a couple of squares of Dairy Milk and then had to be sick at the side of my car in the village High Street. Nice. Then I went home. I felt terrible. It felt like I had swallowed a golf ball... but it was UNDER my band. It was like there was some massive thing I needed to throw up that was stuck under my band. It was voice changing, mucus producing, sweat beading-ly horrible. I was belching and grunting over the bathroom sink and spitting foam whilst DS phoned to cancel my pupils (which made me feel even better after having just been off for 2 weeks holiday!) But after about half an hour the belches subsided and I was exhausted. I went to lie down and slept until 7pm. I got up then and showed a new lodger around the room and decided that I was feeling remarkably well. How strange. I was still all shaky, so I drank some milk and then sucked the milky bar I had bought earlier. No problem. Then I cooked the dinner for everyone and laid the table and sat down to chilli con carne. There was NO way I could eat that in a million years. I had a few mouthfuls but knew immediately I had to HMS. I should have just not bothered, but I was hungry man! So I thought stuff food, and just drank juice. Later in the evening I had some of the left over bread and butter pudding that I had also made for the brood. This was nice because it was soggy and gooey and slipped down a treat. The shakes subsided and that brought Tuesday to an end. So Tuesdays food consisted of a bit of bread, a slice of salami, 1 chocolate bar and a serving of bread and butter pudding. Crap.

Yesterday? Well it was not too different to be honest, but at least I didn't have the whole "I am gonna chuck my band up through its own stoma" problem.

I got up and decided to have a banana. However, the band decided that this was SO not going to happen, and I managed 1 bite. I waited 30 minutes and then was able to drink a couple of sips of coffee. I was dying of thirst, but I just could do it. We went into town and booked a hall for my concert on the 5th July, and then it was only after maybe 2 or so hours had passed since the banana mystery that I finally drank my cold coffee and a bottle of water to boot. I have a habit of taking my coffee with me in the car because this kind of thing often happens, so it was dutifully waiting for me on our return from the shops.

Lunch ended up being the browning banana I had intended to eat for brekkie, as I wasn't that hungry and couldn't be bothered to do anything else. Then I cooked Puttanesca sauce ready for when I got home from work. and off I toddled. I did a full schedule of lessons and drank 1 cup of tea all afternoon, and when I got home I was starving. I fired up the burners under the pasta and then gathered the masses to feeding time. I managed the most POXY portion. It was about 6 quills of pasta and sauce and then a quick HMS and a 30 minute wait followed by 1 more quill and an olive. Rubbish. But I was satiated which is always the oddest thing to get my head around. It just doesn't seem real to be able to get so full on so little food. I MUST get used to this as this is I think the crux of any weightloss problems I have post banding.

So that was dinner and then about 10pm, I was peckish and I had a few slices of salami whilst playing Sims 2. I took a pint of orange juice to bed with me, and that was yesterday. Banana, pasta, Salami and juice.

Today I am feeling tight too. I knew when I rolled out of bed. I swallowed the last of the orange juice that I took to bed with me, and could 'feel' it. That's always a sure sign that there is absolutely No point whatsoever in bothering with breakfast as its a fight that I will not win.

So, shall update later, but that's it right now. Feeling in need of food big time. It seems a long time since I had a full meal, and I really really miss it. Its the swallowing part I miss most. To swallow a big mouthful just once more, would be really nice.

** The Update**

I am a little bit concerned to be fair... I have been able to eat nothing today. I didn't bother with breakfast as I said, and lunch came and went without me noticing it. Then I made a quiche for tonight's dinner, and went off to work. I was at my pupils house where they always give me food and today they had laid on 2 MASSIVE chunks of french bread with butter and jam and a chocolate bar from Thorntons! Phew. So I took a nice bite and as she left, and as soon as my pupils back was turned, I wrapped one of the slabs of bread and jam in the napkin and stuffed it in my bag. All was ok until I tried at the end of the lesson to quickly down the tea she had made and I knew I wasn't going to make it. I got out of the house and into the car, drove a little way down the road and HMS'd on the road.

Then I did another lesson and then went to the meeting and on the way to the meeting started eating the chocolate bar figuring that it wa nearly 7pm and I haven't eaten all day. Soon as I got to the meeting I HMS'd in the toilet. I am now at home, HMS'ing into the sink after having one of DS's crisps.

I know that all the stuff I am managing to eat is junk. This is half the reason I am trying to eat it, because I actually thought it would go down considering it always has before. I also know there is absolutely no point this side of tomorrow that I could eat anything approaching vegetable or meat based in solid form.

So, here ends yet another day of shit eating, shit eating habits and shitty vomiting and feeling... Shit.

Frankly I don't know what to do. shall I go on liquids for a couple of days or should I just persevere with food? I can at least drink, so I am making sure that I do. I have also been taking my berroca religiously because of this rubbish.

Anyone else ever had this problem? Am I too tight? - and if so... how is that possible since my last fill was ages ago?

Wow, I just don't know what to do. I feel like crying to be honest. I cant console myself in anything that will comfort me. I cant even eat goddamn chocolate!

The Seat of Power

Have you ever wondered why the buttocks is one of the most attractive parts of the body on both sexes? Here's the most common explanation I've heard mindlessly repeated: it's attractive because a man with a nice posterior will be better at thrusting during sex. I've also heard that it's purely aesthetic and nonfunctional, like a baboon's. Neither of these make any sense.

The shape of the buttocks comes mostly from the gluteal muscles (maximus and medius), superimposed by a layer of fat. The 'glutes' are some of the strongest muscles in the body, due to their large size and efficient leverage. Thrusting doesn't even come close to tapping into the glutes' tremendous power. What does? Heavy lifting. Sprints. Jumps. In short, some of the most functional full-body movements we perform as humans.

In any full-body movement, the hips are the central source of power. The strongest muscles surround the hips, and muscle strength diminishes progressively as you move further from them. A shapely buttocks is typically a strong buttocks, and a strong buttocks generally means a strong person. So if you want to decide at a glance whether a person is capable of sprinting and jumping after large prey, and then carrying it home, the buttocks is a good place to look.

The buttocks is also a storage area for fat. Humans tend to store a disproportionate amount of fat near their center of gravity: in the abdominal cavity, on the hips and on the buttocks. The right amount of fat indicates a healthy individual. A shapely buttocks is typically attached to someone who is strong and well-nourished. It's not so hard to imagine why we find it attractive.

Real Food VIII: Ghee

All this talk about butter is making me hungry. Richard mentioned in the comments that he bought some ghee recently and has been enjoying it, so I thought I'd post a recipe. Ghee is the Hindi word for clarified butter. It's butter that has had everything removed but the fat. Rich in fat-soluble vitamins and lacking the sometimes problematic lactose and casein, ghee has rightfully been considered a health food in India since ancient times.

Another advantage of ghee is its high smoke point, which is higher than butter because it doesn't contain any protein or sugars. Consequently, food sauteed in ghee has a clean, rich taste.

The recipe is simple but touchy. I recommend using the best butter you can get your hands on. 100% grass-fed, unsalted cultured butter is the best.

Ingredient and materials

• Butter (1 lb minimum)
• Wide-mouth glass jars
• Cheesecloth
• Rubber bands
  

Recipe

1. Place the butter in a saucepan and turn the heat to medium until it's melted.
   
2. Once it begins to boil, turn the heat down to low. It's very important to calibrate the heat correctly. Typically, you will want the burner on its lowest setting. The idea is to evaporate the water without burning the oil. It should boil, but slowly.
3. The melted butter starts out cloudy but gradually clears up as the water evaporates. At the same time, a crust will form on the surface of the ghee and the bottom of the pan. Keep the heat very low.
   
4. Push a portion of the top crust to the side with a spoon to see inside of the saucepan. When the butter looks clear and bubbles only rise from the bottom every few seconds, it's done. You have to be very careful because once the water has evaporated, the fat heats up quickly and burns the crust. This gives the ghee an acrid flavor and color. Make sure to handle the pot cautiously, because hot oil can give severe burns.
   
5. Allow the ghee to cool until it's warm but not hot. Place a piece of cheesecloth over the lid of your jar. Secure it with a rubber band. Pour the ghee through the cheesecloth, into the jar.
   
6. Store ghee in the refrigerator or at room temperature. It keeps much longer than butter.

The picture above is of my last batch of ghee.