Thursday, November 14, 2013

Don’t Eat Toxins

Don’t Eat Toxinsdoughnut

Imagine a world where:
  • diabetes, heart disease, autoimmunity and other modern diseases are rare or don’t exist at all
  • we are naturally lean and fit
  • we are fertile throughout our childbearing years
  • we sleep peacefully and deeply
  • we age gracefully without degenerative diseases like Alzheimer’s and osteoporosis
While this might sound like pure fantasy today, anthropological evidence suggests that this is exactly how human beings lived for the vast majority of our evolutionary history.
Today, most people accept diseases like obesity, diabetes, infertility and Alzheimer’s as “normal”. But while these diseases may now be common, they’re anything but normal. Humans evolved roughly 2.5 million years ago, and for roughly 84,000 generations we were naturally free of the modern diseases which kill millions of people each year and make countless others miserable. In fact, the world I asked you to imagine above – which may seem preposterous and unattainable today – was the natural human state for our entire history on this planet up until a couple hundred years ago.
What was responsible for the change? What transformed us from naturally healthy and vital people free of degenerative disease into a world of sick, fat, infertile and unhappy people?
In a word? The modern lifestyle. And though there are several aspects of our current lifestyle that contribute to disease, the widespread consumption of food toxins is by far the greatest offender. Specifically, the following four dietary toxins are to blame:
  • Cereal grains (especially refined flour)
  • Omega-6 industrial seed oils (corn, cottonseed, safflower, soybean, etc.)
  • Sugar (especially high-fructose corn syrup)
  • Processed soy (soy milk, soy protein, soy flour, etc.)

What is a toxin?

At the simplest level, a toxin is something capable of causing disease or damaging tissue when it enters the body. When most people hear the word “toxin”, they think of chemicals like pesticides, heavy metals or other industrial pollutants. But even beneficial nutrients like water, which are necessary to sustain life, are toxic at high doses.
In their book The Perfect Health Diet, Paul & Shou-Ching Jaminet apply the economic principle of declining marginal benefits to toxins:
It implies that the first bit eaten of any toxin has low toxicity. Each additional bit is slightly more toxic than the bit before. At higher doses, the toxicity of each bit continues to increase, so that the toxin is increasingly poisonous. 1
This is important to understand as we discuss the role of dietary toxins in contributing to modern disease. Most of us won’t get sick from eating a small amount of sugar, cereal grain, soy and industrial seed oil. But if we eat those nutrients (or rather anti-nutrients) in excessive quantities, our risk of developing modern diseases rises significantly.
That’s exactly what’s happening today. These four food toxins – refined cereal grains, industrial seed oils, sugar and processed soy – comprise the bulk of the modern diet. Bread, pastries, muffins, crackers, cookies, soda, fruit juice, fast food and other convenience foods are all loaded with these toxins. And when the majority of what most people eat on a daily basis is toxic, it’s not hard to understand why our health is failing.
Let’s look at each of these food toxins in more detail.

Cereal grains: the unhealthiest “health food” on the planet?

The major cereal grains – wheat, corn, rice, barley, sorghum, oats, rye and millet – have become the staple crops of the modern human diet. They’ve also become the “poster children” of the low-fat, high-carbohydrate diet promoted by organizations like the American Heart Association (AHA) and American Diabetes Association (ADA). If you say the phrase “whole grains” to most people, the first word that probably comes to their mind is “healthy”.
But the fact is that most animals, including our closest relative (the chimpanzee) aren’t adapted to eating cereal grains and don’t eat them in large quantities. And humans have only been eating them for the past 10,000 years (a tiny blip of time on the scale of evolution). Why?
Because plants like cereal grains are always competing against predators (like us) for survival. Unlike animals, plants can’t run away from us when we decide to eat them. They had to evolve other mechanisms for protecting themselves. These include:
  • producing toxins that damage the lining of the gut;
  • producing toxins that bind essential minerals, making them unavailable to the body; and,
  • producing toxins that inhibit digestion and absorption of other essential nutrients, including protein.
One of these toxic compounds is the protein gluten, which is present in wheat and many of the other most commonly eaten cereal grains. In short, gluten damages the intestine and makes it leaky. And researchers now believe that a leaky gut is one of the major predisposing factors for conditions like obesity, diabetes and autoimmune disease.
Celiac disease (CD) – a condition of severe gluten intolerance – has been well known for decades. Celiacs have a dramatic and, in some cases, potentially fatal immune response to even the smallest amounts of gluten.
But celiac disease is just the tip of the iceberg when it comes to intolerance to wheat and other gluten containing grains. Celiac disease is characterized by antibodies to two components of the gluten compound: alpha-gliadin, and transglutaminase. But we now know that people can and do react to several other components of wheat and gluten. The diagram below shows how wheat and gluten are broken down in the body:
diagram of components of wheat
Current laboratory testing for gluten intolerance only tests for alpha-gliadin and transglutaminase, the two components of gluten implicated in celiac disease (highlighted in red in the diagram). But as you can see, wheat contains several other components including lectins like wheat germ agglutinin (WGA), other epitopes of the gliadin protein like beta-gliadin, gamma-gliadin and omega-gliadin, another protein called glutenin, an opioid peptide called gluteomorphin, and a compound called daminated gliadin produced by the industrial processing or digestion of gluten.
So here’s the thing. Studies now clearly show that people can react negatively to all of these components of wheat – not just the alpha-gliadin and transglutaminase that celiacs react to. And the worst part of this is that up until about 2 weeks ago, no commercial labs were testing for sensitivity to these other subfractions of wheat.
This means, of course, that it’s extremely likely that far more people are intolerant to wheat and gluten than conventional wisdom would tell us. In fact, that’s exactly what the latest research shows. Dr. Kenneth Fine, a pioneer in gluten intolerance research, has demonstrated that 1 in 3 Americans are gluten intolerant, and that 8 in 10 have the genes that predispose them to developing gluten intolerance.
This is nothing short of a public health catastrophe in a nation where the #1 source of calories is refined flour. But while most are at least aware of the dangers of sugar, trans-fat and other unhealthy foods, fewer than 1 in 8 people with celiac disease are aware of their condition. 2  A 1999 paper in the British Medical Journal illustrated this well: 3
Graphic depicting incidence of undiagnosed celiac disease
Patients with clinically obvious celiac disease (observable inflammation and destruction of the gut tissue) comprise only 12.5% of the total population of people with CD. 87.5% of those with celiac have no obvious gut symptoms. For every symptomatic patient with CD, there are 8 patients with CD and no gastrointestinal symptoms.
But does that mean patients with CD without gut symptoms are healthy? Not at all. It was long believed that the pathological manifestations of CD were limited to the gastrointestinal tract. But research over the past few decades has revealed that gluten intolerance can affect almost every other tissue and system in the body, including:
  • brain;
  • endocrine system;
  • stomach and liver;
  • nucleus of cells;
  • blood vessels; and,
  • smooth muscle,
just to name a few!
This explains why CD and gluten intolerance are associated with several different diseases, including type 1 diabetes, thyroid disorders, osteoporosis, neurodegenerative conditions like Alzheimer’s, Parkinson’s and dementia, psychiatric illness, ADHD, rheumatoid arthritis, migraine, obesity and more. The table below from the same 1999 BMJ paper depicts the increased incidence of other diseases in patients with CD: 4
table showing associations of other diseases with celiac disease
As you can see, up to 17% of people with CD have an “undefined neurological disorder”. But even that alarmingly high statistic only accounts for people with diagnosed CD. We know that only 1 in 8 people with CD are diagnosed. We also know that those with CD represent only a small fraction of the population of people with gluten intolerance. With this in mind, it’s not hard to imagine that the number of people with gluten intolerance that have “undefined neurological disorders” (and other associated conditions on the list above) could be significantly higher than current research suggests.
Finally, we also now know that when you are gluten intolerant – which 33% (if not more) of you are – you will also “cross-react” with other foods that have a similar “molecular signature” to gluten and its components. Unfortunately, the list of these foods (shown below) contains all grains, which is why some medical practitioners (myself included) recommend not just a gluten-free diet, but an entirely grain-free diet. As you can see, it also contains other foods like dairy (alpha & beta casein, casomorphin, milk butyrophilin) and coffee (which is a very common cross-reactant).
  • alpha-caesin
  • beta-caesin
  • casomorphin
  • milk butyrophilin
  • cow’s milk
  • american cheese
  • chocolate
  • coffee
  • all cereal grains
  • quinoa
  • amaranth
  • buckwheat
  • tapioca
  • rice
  • potato
  • corn
  • sesame

Industrial seed oils: unnatural and unfit for human consumption

Industrial seed oils (corn, cottonseed, soybean, safflower, sunflower, etc.) have not been a part of the human diet up until relatively recently, when misguided groups like the AHA and the ADA started promoting them as “heart-healthy” alternatives to saturated fat.
The graph below shows how dramatically seed oil consumption has risen over the past several decades:
Throughout 4-5 million years of hominid evolution, diets were abundant in seafood and other sources of omega-3 long chain fatty acids (EPA & DHA), but relatively low in omega-6 seed oils.
Anthropological research suggests that our hunter-gatherer ancestors consumed omega-6 and omega-3 fats in a ratio of roughly 1:1. 5 It also indicates that both ancient and modern hunter-gatherers were free of the modern inflammatory diseases, like heart disease, cancer, and diabetes, that are the primary causes of death and morbidity today. 6
At the onset of the industrial revolution (about 140 years ago), there was a marked shift in the ratio of n-6 to n-3 fatty acids in the diet. Consumption of n-6 fats increased at the expense of n-3 fats. 7 This change was due to both the advent of the modern vegetable oil industry and the increased use of cereal grains as feed for domestic livestock (which in turn altered the fatty acid profile of meat that humans consumed).
The following chart lists the omega-6 and omega-3 content of various vegetable oils and foods:
efa content of oils
Vegetable oil consumption rose dramatically between the beginning and end of the 20th century, and this had an entirely predictable effect on the ratio of omega-6 to omega-3 fats in the American diet. 8 Between 1935 and 1939, the ratio of n-6 to n-3 fatty acids was reported to be 8.4:1. From 1935 to 1985, this ratio increased to 10.3:1 (a 23% increase). Other calculations put the ratio as high as 12.4:1 in 1985. Today, estimates of the ratio range from an average of 10:1 to 20:1, with a ratio as high as 25:1 in some individuals. 9
In fact, Americans now get almost 20% of their calories from a single food source – soybean oil – with almost 9% of all calories from the omega-6 fat linoleic acid (LA) alone! 10
This reveals that our average intake of n-6 fatty acids is between 10 and 25 times higher than evolutionary norms. The consequences of this dramatic shift cannot be underestimated.
So what are the consequences to human health of an n-6:n-3 ratio that is up to 25 times higher than it should be?
The short answer is that elevated n-6 intakes are associated with an increase in all inflammatory diseases 11 - which is to say virtually all diseases. The list includes (but isn’t limited to):
  • cardiovascular disease
  • type 2 diabetes
  • obesity
  • metabolic syndrome
  • irritable bowel syndrome & inflammatory bowel disease
  • macular degeneration
  • rheumatoid arthritis
  • asthma
  • cancer
  • psychiatric disorders
  • autoimmune diseases
The relationship between intake of n-6 fats and cardiovascular mortality is particularly striking. The following chart, from an article entitled Eicosanoids and Ischemic Heart Disease by Stephan Guyenet, clearly illustrates the correlation between a rising intake of n-6 and increased mortality from heart disease: 12
landis graph of hufa and mortality
As you can see, the USA is right up there at the top with the highest intake of n-6 fat and the greatest risk of death from heart disease.
On the other hand, several clinical studies have shown that decreasing the n-6:n-3 ratio protects against chronic, degenerative diseases. 13 One study showed that replacing corn oil with olive oil and canola oil to reach an n-6:n-3 ratio of 4:1 led to a 70% decrease in total mortality. 14 That is no small difference.
Joseph Hibbeln, a researcher at the National Institute of Health (NIH) who has published several papers on n-3 and n-6 intakes, didn’t mince words when he commented on the rising intake of n-6 in a recent paper:
The increases in world LA consumption over the past century may be considered a very large uncontrolled experiment that may have contributed to increased societal burdens of aggression, depression and cardiovascular mortality. 15
And those are just the conditions we have the strongest evidence for. It’s likely that the increase in n-6 consumption has played an equally significant role in the rise of nearly every inflammatory disease. Since it is now known that inflammation is involved in nearly all diseases, including obesity and metabolic syndrome, it’s hard to overstate the negative effects of too much omega-6 fat.

Refined sugar: the sweetest way to wreck your health

About 20 years ago, Nancy Appleton, PhD, began researching all of the ways in which sugar destroys our health. Over the years the list has continuously expanded, and now includes 141 points. 16 Here’s just a small sampling (the entire list can be found on her blog).
  • Sugar feeds cancer cells and has been connected with the development of cancer of the breast, ovaries, prostate, rectum, pancreas, lung, gallbladder and stomach.
  • Sugar can increase fasting levels of glucose and can cause reactive hypoglycemia.
  • Sugar can cause many problems with the gastrointestinal tract, including an acidic digestive tract, indigestion, malabsorption in patients with functional bowel disease, increased risk of Crohn’s disease and ulcerative colitis.
  • Sugar can interfere with your absorption of protein.
  • Sugar can cause food allergies.
  • Sugar contributes to obesity.
White table sugar (sucrose) is composed of two sugars: glucose and fructose. Glucose is an important nutrient in our bodies and is healthy, as long as it’s consumed in moderation.
Fructose is found primarily in fruits and vegetables, and sweeteners like sugar and high-fructose corn syrup (HFCS). Naturally occurring fructose is not an essential nutrient, like glucose, but when consumed in the form of whole foods it is easily handled by the body.
The problem with sugar occurs when it is eaten in excess. Unfortunately, that has become the norm in the U.S. A recent USDA report found that the average American eats 152 pounds of sugar each year, including almost 64 pounds of HFCS. 17
Refined sugar is particularly problematic because it tends to promote unintentional overeating. Studies have shown that people that consume a lot of refined sugar do not tend to compensate by reducing calories elsewhere in the diet. This doesn’t happen with fruit or other whole foods that contain glucose or fructose. When people add fruit to their diet, they reduce their calorie intake elsewhere to compensate. Not so with liquid-sweetened beverages like soft drinks. When people add a soda or two a day to their diet, they tend not to reduce consumption of other foods, and thus their calorie intake increases.
This is one area where fructose does appear to be more harmful than glucose. Although people don’t compensate for calories added via glucose or fructose, fructose-sweetened beverages have more detrimental metabolic effects than glucose-sweetened beverages.

Soy: another toxin promoted as a health food

Like cereal grains, soy is another toxin often promoted as a health food. It’s now ubiquitous in the modern diet, present in just about every packaged and processed food in the form of soy protein isolate, soy flour, soy lecithin and soybean oil.
For this reason, most people are unaware of how much soy they consume. You don’t have to be a tofu-loving hippie to eat a lot of soy. In fact, the average American – who is most definitely not a tofu-loving hippie – gets up to 9% of total calories from soybean oil alone.
Whenever I mention the dangers of soy in my public talks, someone always protests that soy can’t be unhealthy because it’s been consumed safely in Asia for thousands of years. There are several reasons why this isn’t a valid argument.
First, the soy products consumed traditionally in Asia were typically fermented and unprocessed – including tempeh, miso, natto and tamari. This is important because the fermentation process partially neutralizes the toxins in soybeans.
Second, Asians consumed soy foods as a condiment, not as a replacement for animal foods. The average consumption of soy foods in China is 10 grams (about 2 teaspoons) per day and is 30 to 60 grams in Japan. These are not large amounts of soy.
Contrast this with the U.S. and other western countries, where almost all of the soy consumed is highly processed and unfermented, and eaten in much larger amounts than in Asia.
How does soy impact our health? The following is just a partial list:
  • Soy contains trypsin inhibitors that inhibit protein digestion and affect pancreatic function;
  • Soy contains phytic acid, which reduces absorption of minerals like calcium, magnesium, copper, iron and zinc;
  • Soy increases our requirement for vitamin D, which 50% of American are already deficient in;
  • Soy phytoestrogens disrupt endocrine function and have the potential to cause infertility and to promote breast cancer in adult women.
  • Vitamin B12 analogs in soy are not absorbed and actually increase the body’s requirement for B12;
  • Processing of soy protein results in the formation of toxic lysinoalanine and highly carcinogenic nitrosamines;
  • Free glutamic acid or MSG, a potent neurotoxin, is formed during soy food processing and additional amounts are added to many soy foods to mask soy’s unpleasant taste; and,
  • Soy can stimulate the growth of estrogen-dependent tumors and cause thyroid problems, especially in women.
Perhaps most alarmingly, a study at the Harvard Public School of Health in 2008 found that men who consumed the equivalent of one cup of soy milk per day had a 50% lower sperm count than men who didn’t eat soy. 18
In 1992, the Swiss Health Service estimated that women consuming the equivalent of two cups of soy milk per day provides the estrogenic equivalent of one birth control pill. That means women eating cereal with soy milk and drinking a soy latte each day are effectively getting the same estrogen effect as if they were taking a birth control pill.
This effect is even more dramatic in infants fed soy formula. Babies fed soy-based formula have 13,000 to 22,000 times more estrogen compounds in their blood than babies fed milk-based formula. Infants exclusively fed soy formula receive the estrogenic equivalent (based on body weight) of at least five birth control pills per day.
Click here for a complete list of studies demonstrating the harmful effects of soy products.

Sunday, September 8, 2013

Are Grains Destroying Our Brains?

Are Grains Destroying Our Brains?

Elevated blood glucose--even within the high-normal range--correlate with shrinkage of the hippocampus (yellow) and amygdala (blue). Image: Nicolas Cherbuin
According to David Perlmutter, MD, we Americans are literally beating our collective brains out with the "Staff of Life."
Dr. Perlmutter, a leader in the emerging field of functional neurology, contends that our grain-heavy diets are a major etiologic factor in Alzheimer's disease and other forms of dementia---diseases that mainstream medicine view as an inevitable consequence of genetics and age.
At conferences across the nation, and in his soon to be published new book,Grain Brain, Perlmutter makes the case that most forms of dementia are a consequence of the hyperglycemia, insulin resistance and chronic inflammation set off by excessive consumption of grain-based foods.
And in his view, almost any grain-based food is "excessive."
"Basically, I am calling what's arguably our most beloved dietary staple a terrorist group that bullies our most precious organ, the brain," writes Dr. Perlmutter in the introduction to Grain Brain, due out in mid-September.
With his unique talent for translating complicated science in simple though accurate terms, Dr. Perlmutter's book outlines the connections between insulin resistance, inflammation, allergic reactions, obesity, and impaired cognitive function.
It's a controversial, though well-argued opinion that will no doubt garner a lot of attention among fans of Dr. Oz, Oprah, and other consumer health media figures. Given the robust growth of the gluten-free movement—in early August, the FDA responded to the surge by issuing an official definition of "gluten free" and began setting standards for GF labeling—Grain Brain is likely to strike a responsive chord with a lot of people.
Though the book goes into considerable detail, its core message is simple: brain diseases are largely preventable, and people can greatly minimize their risk by eliminating—or at least greatly minimizing—carbohydrate intake.
If that sounds far-fetched, consider the following:
• A Japanese study of 1,000 men and women over age 60 showed that those with diabetes were twice as likely to develop Alzheimer's within 15 years, and 1.75 times more likely to develop any form of dementia (Kiyohara Y. Rinsho Shinkeigaku. 2011; 51(11):906-9).
• Hippocampal atrophy is directly correlated with blood sugar levels (Cherbuin N, et al. Neurology. 2012; 79: 1019-1026).
• Impaired glucose tolerance (IGT) during the 6th decade of life doubles the risk of developing Alzheimer's later on.
• A 2006 Mayo Clinic study documented a clear connection between celiac disease and progressive cognitive impairment, including ataxia and peripheral neuropathy (Hu WT, et al. Arch Neurol. 2006; 63(10): 1440-6).
• In the same study, several patients with advanced cognitive decline who went gluten-free showed significant improvements in function, suggesting that the condition is, indeed, reversible.
• Another Mayo study published last year showed that people eating the most carbs had four times the risk of mild cognitive impairment as those eating the least amount (Roberts RO, et al. J Alz Dis. 2012; 32(2): 329-39).
Why Are Grains Bad?
Over a lifetime, grain-heavy diets throw three hard punches to the brain: 1) they elevate blood sugar leading to insulin resistance and increased protein glycation; 2) they flood the body with gluten and other potential allergens; and 3) they fuel mitochondrial dysfunction within neurons, leading to neurodegeneration.
Even whole grains are bad news from a brain perspective, says Dr. Perlmutter, who practices in Naples, FL. To be sure they contain more fiber, which slows the release of sugars. But they're still carb-loaded time bombs, and most whole grains—including rye, barley, spelt, kamut, and bulgur—are packed with gluten and other potentially allergenic proteins.
He holds that many types of fruit are also detrimental to brain function. Though they don't contain gluten, most fruits have very high glycemic indices, and cause surges in blood sugar. Berries are the exception. Sweetened drinks are essentially poisons from a CNS perspective.
The American food pyramid should be up-ended, Dr. Perlmutter says. Rather than having grains and high-glycemic produce at the base, these foods should be consumed in very small amounts—if at all. The base should be vegetables, high-quality proteins and healthy fats. A high-fat diet is far healthier for the brain than a high-carb diet.
Not Your Great-Grandma's Grains
The average American consumes 133 pounds of wheat-derived foods each year. Not only are we eating vastly more grain than our great-grandparents did, we're eating vastly different grains. Through selective breeding, genetic modification and modern agricultural practices, today's wheat contains up to 40 times the gluten as grains cultivated just several decades ago. The grains that Americans now consume share "almost no genetic structural or chemical likeness to what hunter-gatherers might have stumbled upon."
We are challenging our physiology—which has changed very little since the Ice Age--with ingredients for which we are not genetically prepared, says Dr. Perlmutter. Essentially, he's in alignment with advocates of the high-fat, high-protein, low-carb "Paleo" diet.
While it is true that our hominid ancestors did occasionally eat carb-rich foods, access to them was rare, seasonal, and limited. Even in the first millennia of the agricultural age, carb consumption was far lower than it is now. To quote Dr. Robert Lustig, author of the popular book, Fat Chance, "Nature made sugar hard to get; man made it easy."
GrainBrainBookType 3 Diabetes
Dr. Perlmutter views cognitive dysfunction as "Type-3 Diabetes," a predictable CNS manifestation of the same disease processes that show up as symptoms of diabetes in other organ systems. If diabetes is reversible via lifestyle change, so is dementia.
Insulin resistance is at the heart of the process.
"If you're insulin resistant, you have a marked increased risk of cognitive impairment despite normal blood sugar," he said at this year's annual conference of theInstitute for Functional Medicine. "Normal non-diabetic people who have abnormal glucose tolerance tests have higher risk of both non-vascular and vascular dementia."
In the brain, chronic insulin resistance promotes formation of amyloid plaques—a hallmark of Alzheimer's disease—and impairs the ability to break them down. But beta-amyloid really becomes problematic when it is glycated, and glycation is directly correlated with blood sugar levels.
Surges in blood sugar take their own toll. They deplete neurotransmitters such as serotonin, epinephrine, norepinephrine, GABA and dopamine. They also deplete B-vitamins, which are needed to rebuild these spent neurotransmitters.
Brain Shrinkage
Hyperglycemia and insulin resistance actually cause structural changes to key brain regions, as was demonstrated in 2 recent studies which Dr. Perlmutter reviewed at the 2013 Integrative Healthcare Symposium.
Australian researchers studied 266 cognitively normal adults and found that those with chronically elevated fasting plasma glucose had marked hippocampal atrophy after 4 years. "The hippocampus is the neural triage area---the bigger the hippocampus, the better the cognitive function," explained Dr. Perlmutter.
In the Australian trial, called the Personality and Total Health (PATH) study, the difference in hippocampal size between those with the highest versus lowest blood sugars was as great as 10% (Cherbuin N, et al. Neurology. 2012; 79: 1019-1026).
"Even at average glucose levels of 81-90 mg/dl, there were changes in hippocampal size associated with cognitive changes," Dr. Perlmutter noted.
The InCHIANTI study, involving 523 people aged 70-90 years, showed that risk of cognitive impairment correlated strongly with insulin resistance (Geroldi C, et al. Arch Neurol. 2005; 62(7): 1067-72). This finding is even more significant given that subjects had blood sugars within normal ranges. The authors of InCHIANTI, suggest that, "Insulin resistance might contribute to cognitive impairment through a vascular mechanism."
Some of the most impressive data come from the massive Rotterdam study—an ongoing survey of age-associated diseases in nearly 11,000 Rotterdam residents. The investigators found that people with IGT in their mid-50s had double the risk of developing Alzheimer's later in life.
At IHS, Dr. Perlmutter noted that there is a significant correlation between hemoglobin A1c and loss of brain volume. "You lose 0.250% annually even at a HbA1c of 5. In the range of 5.9 to 9.0, you're losing 0.5% of your brain volume every year."
He added that the APOe4 allele, widely recognized as a predictive factor for Alzheimer's, is not as dramatic a risk factor as A1C changes in terms of brain volume change.
Our Generation's Tobacco
Gluten is an addictive substance. Researchers have known this since the late 1970s.
It is digested into polypeptides that cross the blood-brain barrier and bind to morphine receptors, causing a pleasurable buzz. These compounds were named "exorphins" by Christine Zioudrou, the NIH researcher who discovered them. Neuroscientists quickly realized they could block the exorphin effect with opiate-blockers like naloxone and naltrexone.
The exorphin buzz is a big reason why people love carbs, and the food industry has been happy to supply an endless deluge of gluten-saturated fare.
According to Dr. Perlmutter, gluten is this generation's tobacco--- addictive, widely prevalent, previously deemed harmless, and protected by massive industries. Just as rampant tobacco use once fueled an epidemic of CVD, so the nation's addiction to gluten is precipitating a deluge of cognitive dysfunction.
Gluten is actually a complex of proteins, primarily glutenins and gliadins. There are 12 subunits within gliadin, any one of which can trigger inflammation. Anti-gliadin antibodies bind to specific brain proteins that look like gliadins in gluten-containing foods. The result is an inflammatory cascade within the CNS that set the stage not only for Alzheimer's but also Parkinson's, MS, and autism.
Gluten can cause CNS problems even in the absence of GI symptoms. Marios Hadjivassiliou, MD, a British neurologist, articulated this more than 10 years ago.
"It has taken nearly 2,000 years to appreciate that a common dietary protein introduced to the human diet relatively late in evolutionary terms, can produce human disease not only of the gut but also of the skin and the nervous system. The protean neurological manifestations of gluten sensitivity can occur without gut involvement and neurologists must therefore become familiar with the common neurological presentations." (Hadjivassiliou M. J Neurol Neurosurg Psychiatry. 2002; 72(5): 560-3)
AGEs and Aging
One of the main culprits in the development of cognitive problems is glycation. Not only does it increase free radical production, it also causes structural distortions in proteins that can ultimately lead to functional abnormalities.
David Perlmutter, MD
"The brain is tremendously vulnerable to the glycating ravages of glucose, and this is made worse when powerful antigens like gluten accelerate the damage," writes Dr. Perlmutter in Grain Brain.
Formation of advanced glycation end-products (AGEs) correlates directly with blood sugar levels: the higher the glucose, the more AGEs. Two years ago, Yaffe and colleagues at the University of California, San Francisco showed that high peripheral AGE levels correlate with cognitive decline in older adults. This was true for those with and without diabetes (Yaffe K, et al. Neurology. 2011; 77(14): 1351-6).
Dr. Perlmutter strongly recommends measuring AGEs, though he emphasized that they are more than markers of excess blood sugar. In and of themselves, they induce inflammatory cytokines, increase oxidative stress, and mitochondrial dysfunction. This ultimately results in a dangerous feed-forward cycle: mitochondrial failure leads to further insulin resistance and hyperglycemia, which in turn increases glycation.
One reason many people have trouble accepting the connection between insulin-resistance, inflammation and neurodegenerative disease is that the brain has no pain receptors. It is impossible to sense brain inflammation as one would inflammation of the joints, the skin, or the vessels of the heart. By the time symptoms appear, CNS inflammation has been simmering for years, if not decades.
In people already developing early signs of Alzheimer's, the need to focus on AGEs is even more pressing. "Amyloid is a protein. It can be oxidized or non-oxidized. AGE-modulated beta-amyoid becomes more dangerous. We have to stop glycating our proteins," Dr. Perlmutter says.
The good news is that production of AGEs is largely modifiable through diet and lifestyle changes. "We can control the glycation of our proteins, our levels of insulin resistance and oxidative stress through what we choose to eat." The key, he said, is to minimize high-glycemic foods—especially those from grains—and lowering one's overall glycemic load as much as possible.
Dr. Perlmutter will be a keynote speaker at HPC's 2013 Heal Thy Practiceconference. He will outline a comprehensive clinical strategy for helping patients reduce their risk of cognitive disorders, and share practice development tips he's learned in the course of creating his own successful functional medicine practice.

Friday, June 14, 2013

Workout Technology has advanced so much in the last several years:
  • At-home aerobics (outdated)
  • Power walking (outdated)
  • Machine-based circuits (outdated)
  • Cardio, cardio, cardio (outdated)
  • Interval-based weight training (Alive & Well)
But the principles remain the same…
  1. Build cardiovascular endurance
  2. Burn as much fat as possible from every workout
  3. Improve your strength, relative to your body shape/size
  4. Improve exercise efficiency – more results, less time
  5. Balance your body for best results
Build Cardiovascular Endurance:
Building cardiovascular endurance is an important aspect to your exercise program.  This is because you need to improve your heart’s ability to expel blood to the rest of your body (and receive it in return) in order to ensure a healthy state in your body.  Essentially, improving heart function increases chances of survival and decreases risk of diseases like diabetes, heart attack, and stroke.
Cardiovascular fitness also helps to improve lung function and expel more oxygen to the rest of the body.  The elasticity of your lungs improve when you improve your cardiovascular fitness level, and breathing becomes easier.  By requiring less breaths and having a lower resting heart rate, your body undergoes less stress with daily living, and it’s thought that this results in an increased lifespan by several years.
Improved Quality of Life + Improved Quantity of Life = Better Life
We used to think that you had do long, boring cardio in order to improve cardiovascular fitness.  Thanks to the Jabali studies, amongst others, we now understand that you can do about 20 minutes of high-intensity exercise and reap up to 2 hours of moderate-high intensity cardio benefit to your cardiovascular system.
Workout Technology advanced and exercise got easier.
Burn As Much Fat As Possible:
We’ve always wanted to burn as much fat as possible with every workout.  Whether we were counting calories on a treadmill or doing aerobics, the goal was to ‘get a great burn’ and then reap the benefit of our efforts.
Over time, we learned that alternating high and low intensity exercise, combined with resistance training to momentary muscular failure, yielded far better caloric expenditure.  The logic was simple, but the argument was hard to comprehend for awhile…
We learned about EPOC – Excess Post-Oxygen Consumption.
Basically, for up to 48-72 hours after an intense exercise bout, our bodies undergo a repair process.  This repair process removes lactic acid from our systems and repair mini muscle tears that take place from heavy sets to failure.  Any body process consumes energy.  In this case, the energy consumed by EPOC, as our body consumes oxygen for days after an exercise bout to self-repair, is worth 2-3x the number of calories you can burn during a bout of ‘cardio’ on the treadmill.
Workout Technology advanced and exercise got easier.

Improve Your Strength, Relative To Your Body’s Shape or Size:
How many different products have we seen, relative to a specific body size or shape on the market to date?  Whether it’s a product for abs, buns, thighs, women, or men, we’ve seen it all.  One point remains true:
Our bodies are unique, 
and each one responds differently to exercise.
That’s why we’ve had to come up with so many programs.  But I believe one major component is missing… self-assessment.  No one understands your body as well as you do.  With the proper education related to your body, you’ll become immediately aware of what needs to be done in order to succeed.
When trying to improve fitness levels as a whole, assessing your body for fat storage patterns is important, but not because you need to exercise those areas.  Instead, this is important because it is indicative of increased levels of certain hormones in your body.
For example, fat storage in your lower abdomen is indicative of increased levels of cortisol, meaning that your body is too stressed, not that you should do more sit ups and stress it further.
However, it is also important to assess where you are weak or strong, left to right, side to side, or top to bottom.  Your body craves symmetry, and this is dependent upon both strength and length.
In the case of flexibility (or length), this is the closest thing to having a great manual therapist assess every muscle in your entire body for restriction or limitation.  Your body has ‘pain sensors’ where you have restriction, so you can easily find them on yourself.  In fact, it stands to argue that you’ll find your own restrictions more easily than the best manual physical therapist in the world will find them on you.
Once you find your restrictions and learn to release them, your flexibility will finally improve… Rapidly!
Workout Technology advanced and exercise got easier.

Exercise Efficiently – More Done In Less Time:
Everyone wants more for less.  It’s human nature.  By learning how to exercise in the most efficient way possible, one of two things are true:
  1. You get more results in the same amount of time.
  2. You get to exercise for less time and get the same results.
Both seem like rather appealing options, right?
It used to be that exercising for increased efficiency meant regulating your heart rate to be in the ‘fat-burning zone’ of 40-60% max heart rate, or in the ‘cardiovascular zone’ of 60-85% max heart rate.  Now, we know better.  

We know that increased efficiency means improving the demand on all 3 energy systems:
  1. ATP-PC – 0 to 2 second energy system
  2. Anaerobic – 2 to 60 second energy system
  3. Aerobic – 60 seconds and beyond energy system
By depleting and replenishing all three energy systems, we are maximizing caloric expenditure, muscular strength, as well as muscular and cardiovascular endurance.
Effectively, we are not multiplying our results by three, but we are exponentially allowing ourselves to burn up to 9x more calories with this approach.
You Can Burn Up To 9x More Calories 
When You Exercise Efficiently
Imagine what you could do with your flexibility… your body could finally move freely, and your posture could improve in a very short period of time.  Standing up straighter means better oxygen to our bodies, and therefore, more endurance.
More endurance = More Results
Workout Technology advanced and exercise got easier.

Balance Your Body For Best Results:
This is where the importance of strength and length really come in.  Your body is composed of a system of checks and balances:
  • When your heart rate increases (outside of exercise), your blood pressure decreases to prevent too much blood flow at once.
  • When your breathing increases in rate, you exhale more forcefully than you inhale, in order to blow off carbon dioxide and allow room for oxygen.
  • When you build muscle, your body limits your ability to grow if you do not have enough mobility in the group of related muscles, in order to prevent injury to your joints or fracture to your bones.
Your body will literally turn muscle off if it believes it is too short for more growth; and it will build restrictions in muscles that have been over-shortened for a time period, either due to injury, posture, or position.
You should be grateful for the smart body that you have.  But it’s important that you understand how to make use of this process and see it for the advantage it brings you with your workouts.  By learning to properly understand and assess where your body is limiting growth, you are able to restore function to these areas and take control of your future progress.
Flexibility, Mobility, & Activation
Are The Keys To Balance In Your Body.
Workout Technology advanced and exercise got easier.
Have you had trouble gaining flexibility?
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