Celebrity Diabetes ~ Tom Hanks now

Before Paula Deen got in hot water over racial issues, she was the subject of controversy a few years back with her belated disclosure that she had Type 2 diabetes, and then became a spokesperson for Novo Nordisk's Victoza.  The "mainstream" balked, including rebukes from fellow celebrity chefs for using so much butter in her cooking while hiding the effect it had on her health.  When the news hit the LC community, it of course went nuts.  I discussed this pretty thoroughly HERE.  A quick summary might be that the low carbers didn't like that people blamed the fat in her foods and finger pointed at the carbs (ignoring sedentary lifestyle entirely).  Further, they didn't like that she was dieting per mainstream guidelines and using Victoza rather going on a LC diet.   Stress certainly has taken a toll on Deen, but she seems to have maintained her weight loss, perhaps even losing a few more pounds.  It would be interesting to get an update on her condition, but somehow I doubt we will.

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Bump: The Diabetes "Crash" Cure & Pancreatic Fat

Today's 8/15/13 bump was inspired by a comment by Tsimblist (thanks!) alerting me to this paper:  Type 2 Diabetes Etiology and reversibility

Reversal of type 2 diabetes to normal metabolic control by either bariatric surgery or hypocaloric diet allows for the time sequence of underlying pathophysiologic mechanisms to be observed. In reverse order, the same mechanisms are likely to determine the events leading to the onset of hyperglycemia and permit insight into the etiology of type 2 diabetes. Within 7 days of instituting a substantial negative calorie balance by either dietary intervention or bariatric surgery, fasting plasma glucose levels can normalize. This rapid change relates to a substantial fall in liver fat content and return of normal hepatic insulin sensitivity. Over 8 weeks, first phase and maximal rates of insulin secretion steadily return to normal, and this change is in step with steadily decreasing pancreatic fat content.

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Aug. 1 Over the Hump Bump: Baby Your Pancreas? Part II: Go all Jillian Michaels on your Liver?

On Facebook today, Mark Hyman MD (functional medicine doc) posted:

There are no essential carbohydrates. There are essentials fats and essentials proteins, but if you never had any carbohydrates again, you would survive.

The Teaspoon Party

This was brought to my attention but also reminded me that Richard Feinman is at it again with a recent blog post on this no essential dietary carb canard, couched in a history lesson of sorts:  Revolutions. Political and Scientific.  He discusses Claude Bernard finding sugar in a dog that hadn't been fed any carbohydrate.  The question is why ... again ... why ... now?   This idea has earned him an honored place in the group at right.

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Aug. 1 Over the Hump Bump: Baby your Pancreas? Part I: The Tired Pancreas

Another two-fer for the Thursday post bumps again this week.  More explanation for why this set in the next bump.

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Original Publish Date:  7/26/11

In the comments on a recent post on beta cell lipotoxicity, Ned Kock (of Health Correlator blog) posted a link to a post he made a while back entitled:  Lipotoxicity or tired pancreas? Abnormal fat metabolism as a possible precondition for type 2 diabetes.  This article deals with the concept of the "tired pancreas" in the development of diabetes.  It seems that (and hopefully he corrects me if I'm wrong here) Ned and I agree that this is not a likely explanation for diabetes.   Ned summarizes the progression of obesity induced T2 diabetes from Unger & Zhou, 2001.  It is worth mentioning that Unger is often summarily dismissed from the "scientific discussion roundtable" by low carbers because of the unfortunately titled "Gluttony and Sloth" paper, that, even more unfortunately also included a biblical verse.   Unger's hypothesis is very leptin-centric, but not at all incompatible with other lipotoxicity based theories.  Basically, lipotoxicity is the result of dysfunctional adipocytes leading to excessive "spill-over" of fatty acids into circulation and accumulation in ectopic tissues.   Unger & Zhou identify dysfunction in leptin secretion and/or signaling as the initiating factor in this process.  One thing that doesn't quite add up for me here is that I keep finding citations indicating leptin action increases free fatty acids which would seem counterintuitive.  In any case ...

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Chronic Exposure to Free Fatty Acid Reduces Pancreatic β-Cell Insulin Content by Increasing Basal Insulin Secretion That Is Not Compensated For by a Corresponding Increase in Proinsulin Biosynthesis Translation

Coming next in the discussion of diabetes I am going to discuss insulin secretion in greater detail.  I was reminded of this post in the writing process.  So ... Bump!

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Original Publish Date:  4/4/11

Chronic Exposure to Free Fatty Acid Reduces Pancreatic β-Cell Insulin Content by Increasing Basal Insulin Secretion That Is Not Compensated For by a Corresponding Increase in Proinsulin Biosynthesis Translation

JD McGarry contributing author.

{Please note:  Excerpts from the text will be edited somewhat to avoid "cluttering" references, statistical values, and some rounding of numbers.  Text will sometimes be presented in bullet form or with paragraph breaks to ease reading.  It is not my intent to plagiarize nor to alter the content.  If anyone feels I've altered the content in any meaningful way, do please let me know!}  Direct quotes will be indented.

FFA are an important physiological fuel for islets, and act as a supplemental nutrient secretagogue to potentiate insulin release acutely in the presence of glucose.

Translation:   β-cells run on fatty acids but this fuel also serves to stimulate insulin secretion.

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Speaking of Eating Disorders ...

I'm trying to figure out why Stefani Ruper advocates for paleo (for women!) when: {colored emphasis mine, plain bold is hers}

When you discover the paleo diet, it just sort of makes sense in that basic way, and you leap head first into an orgy of statistics and science and success stories.   But for me–as probably for a fair portion of paleo dieters–my excitement was mostly at the promise of being effortlessly thin.  With the paleo diet, I wouldn’t have to feel so restricted.   The “satiation power” of fat and protein would make the burden of my weight maitenance efforts slide off of my shoulders.   I’d eat sardines.  I wouldn’t feel hungry.  I’d be skinny.  Life would be perfect.  Hooray!

Needless to say that wasn’t quite how the story went down at all.   As a matter of fact, it was at this point in my life, for the first time ever, that episodes of overeating became real food binges, in which I might eat half of a pumpkin cheesecake after a whole Thanksgiving dinner, a whole serving tray of gourmet desserts on my birthday, or a few loaves of dessert bread at Christmas parties.  The fact that I had forbidden carbohydrates of nearly all forms from my diet meant that I needed them all the more strongly.  This phenomenon is one of the great monsters I try to tackle with this blog:macronutrient restriction.  If your diet is actively restricting you and making you feel deprived, chances are quite good that food intake, choices, and willpower will all domino behind that.

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Is there any such thing as "safe fat" for diabetics?

So some of the AHS12 videos are now online, HERE.  I'll have some comments on particular presentations, though by no means a majority.  Still, I had to, of course, watch the Safe Starches panel.   For the record, I think Paul & Chris did a good job, especially considering the circumstances, but this thing was an abomination in the making from the get-go.  I'll have more on that in another post.

The whole "debate" goes back to Jimmy Moore's "data dump" post on safe starches.  You remember that one, right?  Is There Any Such Thing As ‘Safe Starches’ On A Low-Carb Diet?  As I said, I'll have more to say on this follow-up, but as one would expect Jimmy expresses his concerns over the safety of starches, and around the 5 minute mark essentially tries to take Paul to task for using the term "safe"!  Citing Webster's Medical Dictionary 

SAFE: not causing harm or injury; especially : having a low incidence of adverse reactions and significant side effects when adequate instructions for use are given and having a low potential for harm under conditions of widespread availability

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Does a high animal protein/fat diet forestall obesity?

Don Matesz had an interesting blog post the other day that I tweeted:  Grass-Fed Animal Products Prevent Obesity and Cardiovascular Disease?  He writes:

Not for Mongolians.

Mongols eat a diet largely composed of milk products, meat, and fat from free-ranging, organic, grass-fed animals. They consume few plant foods because few edible plants grow in the cold continental climate of Mongolia. The climate forced them into a natural experiment in low-carb nutrition based on grass-fed animal products.

I have an interest in Mongolians because there's definitely some influence of these people in my husband's ancestral line.   I went looking for any peer review literature that might address the Mongolians and found an interesting article.  But before that, I also found some other info.  Don points out in a note to WAPF (presumably aimed at their promotion of raw milk) that the Mongols boiled their milk and made cheese from it.  But one of the accountings of the diets comes from the WAPF site:  Diet of Mongolia.  

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Jimmy Moore: Unwavering Dishonesty, The Early Years

Apparently some people belonging to a private paleo FB group aren't receiving Jimmy's recent message of divisiveness too kindly.   One of the reasons I blogged on his latest attempt at dividing the paleo community is because most people -- paleo or low carbers -- who are new to the community, have no clue who this Jimmy Moore guy is and what he stands for.  I would still be hugely surprised to learn that most of the paleo peeps weren't caught off guard when they met Jimmy at AHS11, PaleoFX or any of the other events in the past couple of years.   Just listening to his original podcast or reading the odd blog post (that I'm convinced few if any ever do), it would be easy to see how one might have no clue what really makes this huge influence in the community tick.  And it is exactly his continued influence over the dialog that will keep him on my radar here, especially since he has been so contradictory and disingenuous over the years.  So on IPMG, Jimmy responded to some criticism with two questionable statements:

Anybody who reads my blog regularly knows I am dead honest in all of the things I share there. That's something my readers expect and I give it to them straight.

and 

I've remained quite consistent in my position since the very beginning of my blog in 2005: find what works for you, follow it exactly as prescribed and then keep doing it for the rest of your life. I've never wavered from this message one iota.

These sorts of statements are nothing new for Jimmy, I could have sourced similar from any number of blogs and comments and podcasts over the years ... but these two particular versions are important for their certitude and lack of any wiggle room left for clarity.  Adding in the frequency with which he has repeated such sentiments over the years, and his insistence on continuing to repeat them is rather damning to Jimmy's credibility as any sort of "leader", as well as his personal and professional integrity.   

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Here's an Experiment I'd Like to See

Ahh, well Jimmy Moore has posted his 90 day update on his nutritional ketosis experiment.  While he's refusing to divulge his menus until the 180 day experiment is complete (wanna bet he writes a book about the experience and stupid people will buy it?) he did finally post a typical meal complete with "recipe" and pictures. Why anyone is even interested in mimicking his foods is beyond me, but that's besides the point.

Here's a "meal", I've added Charles' calorie estimates from nutritiondata.com

direct image link

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Diabetes "Crash" Cures: VLCal vs. VLCarb

In light of my post earlier today regarding treating diabetes, I thought I'd bump this post from around a year ago that compared the impact of acute caloric deficit to acute carbohydrate restriction.  If the results don't give one pause regarding low carb always being the best and forevermore necessary diet for diabetics, it's probably hopeless ... but I'll keep trying :-)

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Original Publication Date:  7/4/2011

As I was looking at the results from the VLCal diet that "cured" diabetes, I was reminded of the discussion of "curing" vs. remission of diabetes over at Dr. Davis' Heart Scan blog.   At the time I couldn't recall the thread in which it had occurred but just now stumbled across it.   The post was entitled The Westman Diet.   Westman being Dr. Eric Westman of Duke University whom most of my readers are probably rather familiar with.

In that post Davis cites the following study:

The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus

    mnjjjjjjjjjjjjjj  <- low carb house carnivore input 

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And the Cherry-Picking Baton has been passed.

I've been musing a bit in comments and asides lately over the low carb movement.  When I discovered the LC internet community in early 2009 those were some still heady days.  In retrospect I'm not sure how much it was really growing vs. the hype of same, but it was a thriving community with well traveled blogs and discussion boards.  The number of "big names" touting Taubes' alternate hypothesis was staggering, really, and reports of how the mainstream was finally catching on were frequent.  Looking back, it seems the year or so before were even headier times for low carb.   Fast forward and in 2011 many big names jumped ship, not to mention the readership of blogs like this one increased dramatically.  Even many who remain wedded to LC as the only superior answer to all ills no longer believe TWICHOO to be correct.   Many have retooled their message, clarified their positions, etc.etc.  This is clearly more difficult for some than others -- it's hard to shift gears when your entire persona is inextricably linked to Livin La Vida Low Carb after all.  So in a way, while it by no means excuses their behavior, those like Jimmy and Gary, Feinman and Westman, Carpender and Naughton, etc.etc. at least make sense to me.  These folks have built careers on, and their livelihoods are sustained by LC.   Most of the aforementioned are not about to do a Don Matesz any time soon, and many have reflexively dug in their heels to forge forward -- I hope they at least put blinders on their one trick pony for the sake of humane treatment.

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Drs. Westman & Vernon on Gastric Bypass and Diabetes

So I was getting my morning news fix the other day and of course the new study mentioning gastric bypass as a cure for diabetes was discussed.  One of the many mainstream press articles about two recently published articles in NEJM can be found here.  The full texts of both studies are available online free:  Bariatric Surgery versus Conventional Medical Therapy for Type 2 Diabetes - Mingrone et.al. and Bariatric Surgery versus Intensive Medical Therapy in Obese Patients with Diabetes - Schauer et.al.  I've discussed some other studies previously here.  Lastly on the links for now, I have not followed all contained in this post, but from a surgery center blog we have:  Gastric bypass to ‘cure’ diabetes goes mainstream (you are forewarned that the last one is a "medical tourism" clinic in Colombia).

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Longevity isn't Paleo!

At the end of a recent post, I cited the following study:  Fitness cost of extended lifespan in Caenorhabditis elegans.  

Abstract:  An insulin/IGF-I-like signalling pathway determines the rate of aging of the adult nematode, Caenorhabditis elegans. Mutations in genes encoding this pathway can result in a doubling of lifespan. While such mutations may appear to have little effect on development or fertility, evolutionary theory predicts that large increases in lifespan will not be optimal for fitness. We demonstrate by laboratory natural selection that partial loss of function of the insulin receptor-like protein DAF-2 results in dramatically reduced fitness even under laboratory conditions. Despite long-lived mutants appearing healthy, they exhibit a heavy fitness cost consistent with an evolutionary theory of aging.

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Just Eat Less - Move Moore, Jimmy

Note:  I wrote and never published this post a while back, but after listening to the deluded Jimmy Moore in his podcast conversation with Adam Kosloff, I decided to dust this off and publish it up.  I was brought up in the discussion by Adam, and I'll be responding to that exchange on this blog shortly.  Jimmy, if you're ever going to get control over your situation, you need to listen to Lalonde over Kosloff, Colpo over Eades, Me over Taubes.  Or better yet, the underlying message of this post ... listen to YOURSELF.  Go back and read your own blog and listen to some of your old podcasts.  The answers are right there.  Eat Less, Move Moore.

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Challenge Accepted!

I have a post that I keep re-working addressing this whole "Antagonism against LC" whine from one Jimmy Moore. Perhaps I hit "Publish" in a day or so.  For my newer readers, a little background.  I basically came to the larger LC/paleo/ancestral community from the LLVLC forum where I was a rather prolific participant.  After losing roughly 100 lbs with an Atkins Induction-style pretty Primal friendly diet with planned cheats from 2007-2009 (most of it in the first 10 months), I plateaued out and looked for answers.  LLVLC was a good fit ... I went by Low Carb Cheater.  Shortly after I began following Jimmy's menus blog ... and I'm one with a good memory (something that drives even me crazy at times because I'll often remember exact wordings but not where exactly I read them ... part of the reason for starting this blog).  Because of our podcast but before that a few other times, Jimmy and I had corresponded via email.   I've been criticized for "bashing" Jimmy ... some of that may be fair criticism.  But let me be blunt:  I do not like the man based on our personal interactions.  I think he is a two-faced opportunist with a mean streak he manages to keep under wraps in his public "aw shucks" persona.  His part in the Taubes/FatHead/Moore "confused, stalking, mentally unstable, female" campaign and violation of email privacy over a critical issue can be forgiven but not forgotten.  And I'm human so I'm sure part of those personal feelings are bound to come through when I write posts like this one.  Still, most of the criticism befuddles me given that I'm only pointing out the obvious, that is at least part of what underlies the rift in the LC and Paleo communities.  Jimmy has staked his claim to his Livin La Vida Low Carb webpire, and although it's clearly not working for him anymore,  recent pictures are really worth more than 1000 words regarding part of the problem.  

This picture is from Ancestralize Me! blog.
Please go check out her blog and also check out her other pictures from Paleo FX  too!
She has extensive notes on her blog from the conference and links to FB where she's got much more.

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Puzzle Pieces ... Low Carb & Thyroid

So ... it' been a while, almost a human gestation period, since I reported my miraculous selenium insomnia cure.  In a nutshell, I started taking Se to see if it might help and within days I was sleeping like a baby through the night.  Although I found adding starches in somewhat difficult at first, I've also recently made clear that I'm eating a good 100g/day most days now ... at least that would be the average ... for starch.  I still eat a lot of veggies that I don't bother counting the carbs in and fruit several times a week, so probably getting about 150g perhaps up to 200 total grams of carbs these days.  

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A perfect example of why I post what I do about LC personalities

I frequently read folks wondering out loud why I spend (waste?) the time that I do to post on various low carb gurus and personalities.  It doesn't seem like a worthwhile endeavor at times ... and I must admit I occasionally wonder if it's worth the flack and time either.  And then along comes another LC'er "helping others" with their wisdom.  Some of the people I've written about don't "get me" ... after all they are just every day folks sharing their experiences trying to (selflessly) help others.   That "selflessly" is often silent, sometimes strongly implied in their repeated reminders that this is their goal, and sometimes shouted straight out, lest you not notice the generous benevolence in their actions.  They may even go so far as to remind you of the expense they've endured to bring you the free service you're using .....

For all the touting of how any day now the Insurgency will persevere, of how the low carb message is spreading, etc., the LC community remains a small niche in the wide wide world of dietary lifestyles and weight loss strategies.  It seems to me that, because there are so relatively few, the internet presence is all the more inflated compared to other approaches.  In real life, many who follow more traditional or popular approaches have buddies or support groups they can attend.  Or there are TV shows they can tune into, etc.  Low carbers don't have nearly the options, and in many ways these have dwindled rather than increased in the past five years or so.  Yes, despite the best efforts of Gary Taubes, the drop-off of the Atkins boom was mostly staved a bit but not halted.   It is because the community is so relatively small and intertwined, that the onus is all the more powerful to put out a truthful and realistic welcome mat.

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If this makes it to TV, will they be consistent?

Earlier this week, Dana Carpender let her audience in on a little more news ... and I do mean just a little ... on the potential upcoming LC TV cooking show.  In a short but sweet announcement, she encourages readers to go "Like" the show on Facebook.  We learn the proposed title:  Your Doctor's in The Kitchen.  She describes this as a "low carb cooking and health advice show that Dana and Dr. Jim Carlson hope will find a network home".   Here is Carlson's website.  He wrote a book called Genocide which you can read there (or excerpts, it's unclear) ... I think I read most of what's on the website at one time, but not recently.  As serendipity would have it, Carlson ends the Preface with the same Mark Twain quote that dons the pages of the AWLR blog -- another rebel without a clue....

In any case, Dana encourages people to go like the show on FB to help increase the chances some network might pick it up.  There's not a whole lot of info other than that Dana will play a guest starring role (sidekick?) to Carlson, that "outrageous MD, Nutritional Bio Chemist and hell raising Biker".  Here's what you'll get:

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A Man in the Wilderness ... A Lonely Soldier off to War (on Insulin)

One of my very first albums ... yes ... vinyl albums ... was Grand Illusion by Styx.  I've probably listened to that album all the way through more times than any other, although  Billy Joel's The Stranger might give that a run for the money.  Anyway, I was in the mood for a little self-torture the other day and decided to listen to/read some more recent Gary Taubes interviews.   I couldn't help but have this song pop into my head.   Not a song many are likely familiar with, but soooo apropos!   (Hee hee ... wasn't Tommy Shaw perty?)

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