Kurt Harris MD

An Archevore is someone who eats based on essential principles, and also someone who hungers for essential principles. Take your pick.

Exploring these principles is one of my interests, but not the only one.

So you may find commentary here about other issues in medicine, health, other sciences, or just about anything.

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Thursday
Sep292011

Jimmy Moore inquires about "safe starches"

This morning I got an email from Jimmy Moore inquiring what I thought about Paul Jaminet’s ideas about safe starches as espoused on his blog and in his book The Pefect Health Diet. I am not sure if Jimmy has noted the updates I’ve made in the Archevore diet, or if he has seen where I have come down on the issue of the CIH ( the carbohydrate-insulin hypothesis of obesity), as he would have to be scouring the nooks and crannies of blog comments all over the nutrition blogosphere ; )

I’ve not had time to write the magnum opus blog posts that the repuditation of the CIH really requires (and not much can be added to what Stephan has already written), so I thought this was a good opportunity to get the message outside of my own echo chamber by responding in detail to Jimmy’s inquiry. My response to him is pretty long, and I doubt if he will quote much of it, so I’ve reproduced the email response, with his inquiry broken into bits in italics and my responses afterward in roman.

Kurt, I've been getting a lot of questions this year from my "Livin' La Vida Low-Carb" blog readers about the concepts in Paul Jaminet's book "Perfect Health Diet."  He advocates for eating white potatoes and white rice as part of a low-carb eating plan.

I also have come to see most starchy plant organs as perfectly legitimate fuel sources. 

Low carb plans have helped people lose fat by reducing food reward from white flour and excess sugar and maybe linoleic acid. This is by accident as it happens that most of the "carbs" in our diet are coming in the form of manufactured and processed items that are simply not real food. Low carb does not work for most people via effects on blood sugar or insulin "locking away" fat. Insulin is necessary to store fat, but is not the main hormone regulating fat storage. That would be leptin.

My reading of the anthropology and ethnology literature, as well as my current understanding of biochemistry and metabolism, lead me to see the human metabolism as a multi-fuel stove, equally capable of burning either glucose or fatty acids at the cellular level depending on the organ, the task and the diet, and equally capable of depending on either animal fats or starches from plants as our dietary fuel source, depending on the biome (biological environment) we find ourselves born in or that we migrate to. 

We are a highly adaptable species. It is not plausible that carbohydrates as a class of macronutrient are toxic.

Diabetics need to avoid high carbohydrate intake the same way those with gall bladder disease need to avoid fat, but carbohydrates do not cause obesity or diabetes and fat consumption does not cause gall bladder disease (in fact low fat diets may contribute to gallstone formation via stasis) 

Here's a one-page explanation and illustration of Jaminet's program:http://perfecthealthdiet.com/?page_id=8

Several places in the book and on Jaminet's blog (http://perfecthealthdiet.com) he specifically warns against the danger of a very low-carb diet (defined as less than about 300-400 calories per day (~100 grams) from so-called "safe starches"--taro, plantains, yams, white potatoes, sweet potatoes, white rice and berries) because less than this leads to the risks, including:  1) "insufficient production of mucus in the digestive tract" leading to dysbiosis

I have not looked into that claim enough to comment in detail, but it seems plausible. 

 2) vitamin deficiencies (he particularly mentions Vitamin C and glutathione 

Yes I would agree with that. Whites and sweets are loaded with ascorbic acid.

on pages 253-254)In particular he emphasizes these calories need to come from "safe starches and berrries" and "don't count vegetables as as a carb source (because) they are a fiber (and therefore a fat) source" (page 45).

My list is white potatoes, sweet potatoes, white rice and bananas. If more exotic fare like plantains and taro is available to you, that is fine, too. Except for white rice, these are all whole food starch sources with good mineral and micronutrient content that have been eaten in good health for thousands of years in many environments by genetically diverse populations. Many of these plants have spread far from their biomes of origin and serve as staples for populations who have adopted them with success over just the past few thousand years.

These starchy plant organs or vegetables are like night and day compared to most cereal grains, particularly wheat. One can eat more than half of calories from these safe starches without the risk of disease from phytates and mineral deficiencies one would have from relying on grains.

White rice is kind of a special case. It lacks the nutrients of root vegetables and starchy fruits like plantain and banana, but is good in reasonable quantities as it is a very benign grain that is easy to digest and gluten free. 

I think consumption of quality animal products is the sine qua non of a healthy diet. 

Once you have that, then eating starchy plants is more important for nutrition than eating colorful leafy greens - the veggies that are high fiber and low starch. (Some green leafy vegetables are good sources of folate and along with some fruits are sources of flavonoids that may benefit you via hormesis.)

I view most non-starchy fruit with indifference. In reasonable quantities it is fine but it won't save your life either. I like citrus now and then myself, especially grapefruit. But better to rely on starchy vegetables for carbohydrate intake than fruit.

Primitive populations practicing horticulture or hunting and gathering do not eat a lot of big green salads with lots of variety, but they do eat healthy starchy plant organs with monotony on top of their foraged animal foods.

Eating a very low carb (VLC) diet for a period of time can be a good fat loss maneuver, acting via the effects of ketosis on appetite suppression. I also like to see people limit themselves to two or three meals a day with absolutely no snacking, and it may give benefits via hormesis for longer periods of fasting (24 hours or more) once in a while.

But a long term VLC ketogenic diet is not a good idea. It does not mimic the ancestral diet in general, even if some populations have tolerated it when they had to. There is no need for most people to do it to lose fat, as food reward effects are more powerful. I would advocate long term ketosis in those with neurodegenerative brains diseases like Alzheimer dementia and Parkinson disease, and a 10 day water fast followed by long term ketogenic diet is worth trying if you have cancer. 

But I would not recommend VLC ketosis as a long term way of life the way I would not recommend running a half marathon every day, or lifting weights to failure on a daily basis, or taking chemotherapy drugs when you don't have cancer. Ketosis probably stresses the body and works via hormesis. But the clean up and repair response cannot happen if there is no rest from it. 

A recent post he wrote for cancer patients revealed his recommendion of obtaining 400 to 600 glucose calories a day, mainly from these safe starches. He says it is important to avoid a glucose deficiency, since glycosylated proteins are the means of intercellular coordination, and defects in glycosylation are characteristic of the cancer phenotype.

My arguments are based more on ethnography and anthropology than some of Paul's theorizing, but I arrive at pretty much the same place that he does. I personally eat around 30% carbohydrate now and have not gained an ounce from when I ate 10-15% (and I have eaten as high as 40% for over a year also with zero fat gain) If anything I think even wider ranges of carbohydrate intake are healthy. 

One can probably eat well over 50% of calories from starchy plant organs as long as the animal foods you eat are of high quality and micronutrient content. 

Grass fed ruminants, pastured butter and eggs and wild caught cold water fish are the kernel of a healthy diet, but the fuel source can be larger than the kernel on a caloric basis if the kernel is high quality and consistent.

He notes, "You don’t want to aggravate this with a self-induced glucose deficiency." I'd like to write a blog post about this topic of "safe starches" to help my readers understand fact from fiction and will quote from your response.  THANK YOU! If you cannot assist me, then please let me know so I ask someone else to contribute.

I've given you plenty to quote from, Jimmy. Go for it!

 

 

 

Saturday
Sep172011

Stress does not imply hormesis

 

OC writes in the comments:

I was just reading your post on hormesis and plant toxins.  Why would wheat (1 slice of bread once or twice per week) or an ocassional teaspoon of peanut butter not also cause hormesis.  Is it absolutely determined that these substances are unhealthy, or is this also theoretical?  I ask because my mom eats pretty healthy, but it's still difficult for her to give up her toast in the morning.

It's a non sequitur to assume that every stress or toxin must have or even might have a hormetic effect.

There is not likely any hormesis to be found with cerebral concussions, skin lacerations or lead oxide ingestion.

These won't kill you in limited amounts but they have no mechanisms where the body's response leaves you physiologically "better off" than before.

I am not saying that there is anything necessarily that harmful in a non-celiac eating a little bread, or anyone smoking a cigarette now and then, or not getting enough sleep once in a while, or anything else not wise done only once in a while. I am saying that if there is any damage associated with these behaviors, you can't automatically propose they are hormetic. You need evidence based on an actual mechanism to say they might be.

If your mom is at optimal weight and has no celiac disease or auto-immune fellow travelers of celiac, and one slice does not beget another (the main issue with all flour containing "foods") then, a slice of bread a day may be no big deal.

It's not the ten commandments, here folks, it's a framework. As long as you are honoring more in the observance than in the breach, you are on the right track.

 

Tuesday
Sep132011

Robb Wolf Podcast

I did this interview with the inimitable Robb Wolf - current Sachem of the paleo world and all-around good guy - just last friday.

Warnings may be in order.

I told Robb I was woefully under-read and had been out of the loop over the past few months, so he should be prepared for hearsay and rank speculation.

The interview was ex tempore and I had no knowledge of the questions beforehand. So there are a lot of verbal sidebars to make sure listeners know the context of some of my answers. These detours, when combined with some apparent digital gaps in the audio, make me sound as if I have ADD and aphasia at the same time, at least in some spots.

The interview is rather long at 1:45.

I've also updated my headshot. I hate it when people use ancient photos to represent themselves. There is a chiropractor in my town who often says hello at the grocery store, but I sometimes fail to recognize him as his photo in newspaper ads is from the Reagan administration.

Tuesday
Sep132011

Archevore Diet Revised

The all vegan version is now up.

Not really.

But I did just spend several hours doing a needed update. I think this is about version 3.0 since the original back-of-the-envelope diet I first put on the web in June 2009. That was a diet I had been using successfully clinically for more than two years.

The emphasis on animal products remains.

The emphasis on real whole foods - kill it or dig it up with a stick - remains and is enhanced.

Macro ratios had already been de-emphasized in v 2.0, but that has now been made even more explicit in the steps, and not just in the coda. 

Things which in my mind were "givens" but had been pointed out to me were not clearly emphasized have been made more explicit, like sleep and eating some offal.

I've deleted references to legumes other than avoiding soy and peanuts, as other legumes seem more and more benign to me.

It remains congruent with, and is perhaps now more so with other whole foods diets that I consider "Paleo 2.0" approaches, like that of Chris Kresser, Paul Jaminet, Chris Masterjohn (he won't force you to eat wheat) and J Stanton, and with more potatoes and less steak, Stephan Guyenet

I've not had a chance to do big blog posts about food reward yet. Those who might have seen some comments of mine elsewhere will see I find merit in the idea, but I don't know its ontological status yet.

Whether reducing food reward is restoring the EM2 or whether it is just a useful fat loss maneuver I am not sure. Either way, I think that is part of how diets like mine and maybe all diets may work, so I have emphasized that a bit more in the rank ordering.

There is also a notable but not strictly scientific bias I have used for this re-write.

It could fairly be called data mining or reverse engineering, but I've tried to write the steps such that most of the weight optimization failures that I know of would have not been following the new steps.

For example, I know of people who failed despite eating very low carb, but I cannot think of many that actually ate only twice a day with no snacks, never ate from a box, avoided restaurants and never ate ANY liquid calories, including milk and cream. So this has resulted in modifications that make my own current diet noncompliant in a few ways (I still add cream to my coffee), but I think these changes make it more universal.

This does seem to work well for many people, but nothing works for everyone.  If it optimizes your weight and health and you are satisfied, you can always break a few rules and see what you can still get away with.

I'll try to do a re-write of "how to lose weight" sometime soon and add more therapeutic tricks for when the whole foods low-NAD idea is not enough.

Tuesday
Apr122011

Smoking Candy Cigarettes - revised version on PT

please click through HERE to read the revised, more general version of this essay and help support this blog.