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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Friday
Jun192009

Fish Oil - or not?

Let's start with some terms. Let's call an artificial or synthesized substance that we consume in addition to food a drug, and a more or less "natural" substance in artificially concentrated amounts a supplement.

It should be obvious by now that I generally don't believe in drugs or supplements. If you are deficient in a substance that you are not getting in your diet or that your body would normally manufacture but doesn't, that is replacement. Examples: a 35 year old woman who is hypothyroid due to autoimmune disease from eating wheat needs to take synthroid; a 42 year old woman has premature menopause from a lifetime of hyperinsulinism and uses hormone replacement therapy; a Naval officer does a three month underwater tour on a nuclear submarine and takes vitamin D to compensate for his deficit of normal Vit D production caused by lack of exposure to UVB from sunlight.

If one eats properly in a manner to which we are adapted, the law of unintended consequences would dictate that introducing extra amounts of any specific substance, whether a "natural" micronutrient, a "vitamin" or a big pharma drug developed in a laboratory, is more likely to do harm than good, the same way randomly adding a part to a piece of carefully designed machinery is more likely to screw it up than improve it.

My reading of the available evidence is that supplementation only is of benefit if you are actually deficient in something. Trials of "excess" antioxidant vitamins have provided zero benefit, for example.

If you are supplementing with fish oil, it is to counteract the excess Omega 6 fatty acids in your diet. Maybe we should call that compensatory supplementation - you are compensating for something screwed up in your diet.

It is far and away preferable just to not eat the excess Omega 6 fatty acids in the standard american diet in the first place. 

Don't cook with seed oils. Corn, canola (rapeseed), peanut, saffllower, cotton, margarine, even olive oil.... are all seed oils.

Don't eat processed or fried foods that contain them. 

If you are eating lots of seed oils, you would have to take quite a lot of fish oil to counteract the effects of the excess O 6s. It may help, but is much closer to the EM2 to just cut out the O-6s in the seed oils.

My advice to take the fish oil was a bit of a throwaway. It is more theoretical than proven, and I don't do it myself as I mostly eat wild game or grass-fed bison and only infrequently eat chicken or pork.

Visit Peter's blog here and read his biochemistry heavy posts for his rationale on this. He points out that the Pork and Chicken may be more of a worry than the beef regarding the fatty acid ratios, but remember that he is in the UK and beef here in the 'states is likely worse as it's more corn fed.

Peter points out that extra O 3 fatty acids may not be healthy if you have high carb consumption, but are probably good on LC and high fat diet.

It is all rather complex. Do you see my point now about randomly "improving" a presicion machine and assuming it will run better?

PaNu assumes the machine will run best on the proper fuel, not that adding a magic ingredient to the gas tank, (like STP in the 1960's) will make it run better!

Possible sources of fish oil include cod liver oil and sardines tinned in olive oil or water. I do eat a few sardines because I like them.

I take no fish oil.

I do take Vitamin D (which is not a vitamin) and think that is way more important than fish oil. I'll post more on that later, but I will be raising my recommended dose on that soon. 

Wednesday
Jun172009

What About Diet Soda?

Some of you may be aware of the observational study reported a few years ago - it reported that consumption of diet soda seems to independently correlate with the risk of metabolic syndrome (high blood sugar and insulin levels).

Now, there are a few ways this could occur;

1) Although they "control" for other factors like sugar consumption and calories, in any observational study, factoring out other variables is always mathematically supported guesswork. There may always be covariance with unknown risk factors that are inadequately accounted for or measured.

2) Artificial sweeteners, I believe, condition you to crave sweets. I have only personal and anecdotal clinical experience to support this, but it seems reasonable. I notice if during a long fast I drink diet soda, I get hungry about 15 minutes later every time.

3) There is some evidence there may be a physiologically significant insulin response with artificial sweeteners just due to the sweet taste- even if small, the corresponding drop in blood glucose may be exagerrated by the fact no glucose is consumed - when blood glucose drops, other hormones rise in response, stimulating your appetite. Of course insulin itself drives fat storage and decreases insulin sensitivity, so there may be direct unhealthy effects as well.

4) When it comes to artificial substances like aspartame, that we have even less experience consuming than the cereal grains I am leery of, the precautionary principle would dictate avoiding these substances.

As important as sucrose and HFCS avoidance? Probably not, but I don't recommend any artificial sweeteners. Once you are deconditioned to sugar, they will just "taste funny" anyway.

Wednesday
Jun172009

PaNu - Raw or Cooked?

For an excellent discussion of the role of cooking in human evolution, including a fairly convincing argument that cooking (not just control of fire) began with the transition from H. Habilis to H. Erectus, see the book Catching Fire by Harvard paleoanthropologist Richard Wrangham.

All food sources I discuss assume that cooking is pre-agricultural behavior and that we evolved to eat most of our food cooked. The only paleolithic diet that is substantially raw food would be for chimpanzees.

http://www.amazon.com/Catching-Fire-...5035008&sr=8-1

Wrangham's book has a good discussion of how cooking allowed the human gut to shrink, and thereby freed up metabolic energy that could be devoted to brain growth. Increased meat-eating enabled by more sophisticated and efficient hunting of large mammals and particularly, increased animal fat eating beginning about 4-800,000 years ago likely enabled further increases in brain size (brain growth is highly fat-dependent). 

Wednesday
Jun172009

6) Intermittent fasting and infrequent meals (2 meals a day)

EDIT 1/8/2010: Step 6 used to be intermittent fasting. I now view IF as a useful fat loss technique, and no longer see it as necessary to achieve the EM2. Ketosis may prove to be therapeutically useful ( already is for brain degenerative disorders) for cancer prevention or treatment, but I do not think being in ketosis or frequent IF is necessary to be healthy generally. I still believe in the practical advantages of using animal fats as a fuel source.

 

Step 6 is a cultural counterweight to all the stupid advice you see about "frequent healthy snacks" in the mainstream media. We are told to eat frequent snacks because the standard american diet with 55% carbs has you metabolically and emotionally tethered to frequent boluses of glucose.

Go watch a kid's soccer game- they can't play for 15 minutes without a break for cookies or corn-syrup-laden juice boxes or gatorade - our children are sugar junkies and the advice to eat frequently is just advice to not stray too far from your dealer so you can get a fix when your blood sugar starts to crash!

So I agree with Gary Taubes that we should listen to our bodies, but only after we have kicked the cocaine, the alcohol, the cigarettes the sugar, and the cereals.

Otherwise our bodies are likely to tell us we need something that is not good for us.

My experience has been that without the frantic hunger of a glucose-eater, I can eat at whatever time is convenient. I eat the right types of foods, with no measurement, counting or weighing whatsoever, and I stop eating when I am satisfied. My weight has been absolutely stable eating this way for almost 2 years, putting the lie to the idea that you need to "count calories' to keep weight off. Our weights and appetites are under hormonal control, and our bodies regulate them quite precisely at given macronutrient ratios and the hormone levels that result.

I began to fast spontaneously a few months into eating low carb (my percentages are about 65% fat, 25% protein and 10% carbs). On LC, the character of hunger changes completely. Without swings in blood glucose, and with cellular adaptation towards fatty acid metabolism, the "sick' sort of hunger that most people think of as hunger goes away. I find that I can arbitrarily fast for up to 18 hours with no discomfort whatsoever. If the goal is to keep your insulin levels low, it is only logical that increased intervals between meals increases the amount of time spent in the fatty-acid-fueled state, and less in the pro-inflammatory, oxidative stress-causing state where your body is trying to deal with excess calories, especially from glucose. I believe intermittent fasting and infrequent meals decrease the hormonal signals that lead to disease and the hormone sensitive degenerative diseases that we think of as "aging".

Advantages of infrequent meals:

1) Enhanced metabolic training in the direction of fat metabolism

2) Lower insulin levels and fewer insulin related diseases (Metabolic syndrome, degenerative diseases, Alzheimer's, common cancers)

3) Greater tolerance for fasting makes it easier to tolerate not eating - this give you "metabolic headroom" -it makes you more functional and resilient - You are a Porsche with a 40 gallon gas tank instead of a truck running on lead acid batteries.

4) If you exercise while fasting, the lack of insulin in the fasting state improves the fat-mobilizing and insulin-sensitizing benefits of the exercise.

I eat around noon and again about 9 pm most days. So every 24 hours has a 15 hour fast and once in a while up to 18 hours. Please understand that this is in no way uncomfortable and my weight has been stable at 157-158 lbs for over year. It's not some kind of deprivation or an ascetic experience. I have no idea if this is better than 3 meals a day with a 24 hour fast once a week. This is just what I do spontaneously, but my reading of the literature backs it up as beneficial.

I am sure my regime is healthier than the 5 meals a day "The Zone" or other pseudoscientific diets tell you you must have, or the advice to snack constantly I get from brochures at my local YMCA. Hunter-gatherers tend to eat a few leftovers in the morning, hunt all day and then have a big meal at the end of the day - sounds pretty similar. I doubt if in paleolithic times they very often fasted on purpose, but I do believe they were adapted to food scarcity.

Saturday
Jun132009

Using Dairy to substitute Fats for Carbohydrates

Why do I advocate whole milk and cream but in later steps suggest eliminating dairy?

The 12-step list assumes we are starting with the standard american diet. I have found that step one is very difficult without the immediate introduction of fats to substitute for the excess of sugar and wheat flour. Following an "eat what they ate" paleolithic diet has the flaw of eliminating dairy as not “orthodox paleolithic”. This is a mistake as the best weapons you have to replace unhealthy carb intake with fat in a convenient fashion (without eating brains, liver and marrow of wild game every day) are butter and milkfat. Remember, the paradigm is about paleolithic metabolism, not paleolithic food re-enactment!

Step one is enabled by taking the milk most people are already drinking and ramping up the fat content. Skim milk is less than 0.5% fat by weight and so is mostly water with milk sugar or lactose, and milk protein, including casein. Whole milk is 3.2% fat by weight and has 50% calories from fat, half-and-half is about 12% fat by weight and most of the calories are therefore coming from fat. (Cream of course avoids most of the lactose and casein because it's nearly all fat.) The satiety you get from the increased fat will make the step one elimination of sugar, HFCS and white flour possible. Step one and two really need to be simultaneous to be effective. My “diet” is more a high-fat prescription than a low-carb one. I believe that not only is saturated fat not harmful, but it is actually may be a key component to EM2 in a food-abundant environment.

Cream, butter, and cheese have little to no lactose as it has been either skimmed off or consumed by fermentation.

In addition to lactose intolerance, which is very common, there can be an immunologic reaction to casein (edit - and whey as well), the protein in milk.

Cream and butter are mostly fat of course, but both milk and cheese have casein. I do not think dairy is nearly as significant on a population basis as grain lectins, but it may be an issue. So I generally view butter and heavy cream as excellent and cheese and milk as less so. Most who have difficulty with dairy are just sensitive to the lactose, but there can be immune system issues with casein found in milk and cheeses. I believe casein serving as a molecular mimic to self antigens, and therefore causing autoimmune diseases, mainly occurs in the context of an already leaky gut. So if you do not have Wheat Germ Agglutinin and other grain lectins in your diet, the casein is not likely to leak into your blood stream. Multiple sclerosis may be linked to both gluten grain consumption and milk casein in this way. That is why I believe eliminating gluten grains minimizes the threat of dairy for most people. I believe getting to step 3 makes the milk prescription in step 2 safer in this way.

The advice to move milk up the list if you are sensitive just acknowledges that some are lactose intolerant and some may (theoretically) not tolerate the casein even after gluten grain elimination. (although some may be lactose intolerant and just think it's "normal")

I myself consume copious amounts of butter and cream, half and half and occasionally whole milk - but, no surprise, I consume zero gluten grains.

Again, the last two steps of dairy elimination are more for theoretical completeness as I find much less scientific evidence indicting dairy than grains. Dairy is not paleolithic historically, but as a relatively ubiquitous food class, definitely helps in acheiving the EM2 - the evolutionary metabolic milieu of low insulin levels and mimimal toxins from modern cereal grains.

The PaNu EM2 is not a diet composed of prehistoric food items, it is a metabolic state that we are trying to live in while eating foods that exist now.

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