One of the things I've been thinking about lately is the possibility that intestinal damage due to gluten grains (primarily wheat) contributes to the diseases of civilization by inhibiting the absorption of fat-soluble vitamins. If it were a contributing factor, we would expect to see a higher incidence of the common chronic diseases in newly-diagnosed celiac patients, who are often deficient in fat-soluble vitamins. We might also see a resolution of chronic disease in celiac patients who have been adhering faithfully to a long-term, gluten-free diet.
One thing that definitely associates with celiac disease is bone and tooth problems. Celiac patients often present with osteoporosis, osteopenia (thin bones), cavities or tooth enamel abnormalities (thanks Peter).
An Italian study showed that among 642 heart transplant candidates, 1.9% had anti-endomyosal antibodies (a feature of celiac), compared with 0.35% of controls. That's more than a 5-fold enrichment! The majority of those patients were presumably unaware of their celiac disease, so they were not eating a gluten-free diet.
Interestingly, celiac doesn't seem to cause obesity; to the contrary. That's one facet of modern health problems that it definitely does not cause.
The relationship between cancer and celiac disease is very interesting. The largest study I came across was conducted in Sweden using retrospective data from 12,000 celiac patients. They found that adult celiac patients have a higher overall risk of cancer, but that the extra risk disappears with age. The drop in cancer incidence may reflect dropping gluten following a celiac diagnosis. Here's another study showing that the elevated cancer risk occurs mostly in the first year after diagnosis, suggesting that eliminating gluten solves the problem. Interestingly, celiac patients have a greatly elevated risk of lymphoma, but a lower risk of breast cancer.
There's a very strong link between celiac and type I diabetes. In a large study, 1 in 8 type I diabetic children had celiac disease. This doesn't necessarily tell us much since celiac and type I diabetes are both autoimmune disorders.
One last study to add a nail to the coffin. Up to this point, all the studies I've mentioned have been purely observational, not able to establish a causal relationship. I came across a small study recently which examined the effect of a high-fiber diet on vitamin D metabolism in healthy (presumably non-celiac) adults. They broke the cohort up into two groups, and fed one group 20g of bran in addition to their normal diet. The other group got nothing extra. The bran-fed group had a vitamin D elimination half-life of 19.5 days, compared to 27.5 for the control group. In other words, for whatever reason, the group eating extra bran was burning through their vitamin D reserves 30% faster than the control group.
Unfortunately, the paper doesn't say what kind of bran it was, but it was probably wheat or oat (**Update- it's wheat bran**). This is important because it would determine if gluten was involved. Either way, it shows that something in grains can interfere with fat-soluble vitamin status, which is consistent with the staggering negative effect of refined wheat products on healthy non-industrialized cultures.
Add to this the possibility that many people may have some degree of gluten sensitivity, and you start to see a big problem. All together, the data are consistent with gluten grains interfering with fat-soluble vitamin status in a subset of people. As I discussed earlier, this could contribute to the diseases of civilization. These data don't prove anything conclusively, but I do find them thought-provoking.
Thanks to Dudua for the CC photo
I saw a movie a few nights ago called 'The Dhamma Brothers'. It's about a meditation program at Donaldson correctional facility in Alabama, one of the most violent prisons in the country. Two Bhuddist teachers of Vipassana meditation led a 10-day silent retreat for a volunteer group of inmates. They got up at dawn and meditated for several hours each day. Some of the inmates went through an amazing transformation.
They were forced to confront and accept the horrible crimes they had committed. When you aren't allowed to talk for 10 days, and all you have are your thoughts to keep you company, it's hard to ignore your feelings. Many of them had breakdowns as they felt the full force of their own suffering for the first time.
At first, the warden was skeptical that the prisoners were just acting to get parole; "fake it 'til you make it". Then he started noticing major changes in the inmates' behavior. They became less violent and easier to deal with. Some of them left their gangs. Even after the program was discontinued thanks to an overzealous chaplain, many of the "Dhamma brothers" continued meditating on their own.
It's hard to doubt a grown man's sincerity when you see tears running down his cheeks. These men were hardened criminals, most of them serving life sentences for murder, who rediscovered perspective and humanity simply by spending focused time with themselves.
Meditation is a powerful tool. There are two types of knowledge: intellectual and visceral. You can read books until you're cross-eyed and you will never connect with the fundamental, animal, visceral side of living. We like to think of ourselves as rational, conscious beings. It's reassuring to us. We're in control of our minds and therefore our lives. But that's more illusion than reality.
Neuroscience and meditation have shown us that the human mind is like a monkey riding an elephant. The monkey is our conscious and the elephant is our subconscious. The monkey can tell the elephant where to go, but ultimately the elephant is going to do what it wants. The monkey likes to be in charge however, so it retroactively decides it was the one that chose the direction.
To illustrate the point, imagine doing a simple algebra problem. Do you have to go over everything you ever learned about algebra in your head to solve that problem? No, your subconscious navigates the strata of accumulated knowledge and practically hands you the answer. What happens when you decide on an entree at a restaurant? Do you make a pro/con list for each item and weigh them accordingly? Or do you decide based on a feeling? Where does that feeling come from?
Meditation is plugging back into the vastness of human experience. It's acknowledging that your conscious, declarative mind is only a small slice of the pie.
Activator X, the almost-mythical vitamin discovered and characterized by Weston Price, has been identified! For those of you who are familiar with Weston Price's book 'Nutrition and Physical Degeneration', you know what I'm talking about. For the rest of you, allow me to explain. Weston Price was a dentist and scientist in the early part of the 20th century. Practicing dentistry in Cleveland, he was amazed at the poor state of his patients' teeth and the suffering it inflicted. At the time, dental health was even worse than it is today, with some children in their teens already being fitted for dentures. Being a religious man, he could not bring himself to believe that 'physical degeneration' was what God intended for mankind. He traveled throughout the world looking for cultures that did not have crooked teeth or dental decay, and that also exhibited general health and well-being. And he found them. A lot of them. These cultures were all considered 'primitive' at the time, and were not subject to the lifestyles or food choices of the Western world. He documented, numerically and with photographs, the near-absence of dental cavities and crooked teeth in a number of different cultures throughout the world. He showed that like all animals, humans are healthy and robust when occupying the right ecological niche. Price had a deep respect for the nutritional knowledge these cultures curated. He also documented the result when these same cultures were exposed to Western diets of white flour, sugar and other industrially processed foods: they developed rampant cavities, their children grew with crooked teeth due to narrow dental arches, as well as a number of other strikingly familiar health problems. I think it's worth mentioning that Price's findings were universally corroborated by doctors in contact with the same cultures at the time. They are also corroborated by the archaeological record. Many of his findings were published in respected peer-reviewed journals. 'Nutrition and Physical Degeneration' is required reading for anyone interested in the relationship between nutrition and health.Naturally, Price wanted to understand what healthy diets had in common besides the absence of white flour and sugar. Having studied cultures as diverse as the carnivorous Inuit, the dairy-eating Masai and agricultural groups in the Andes, he realized that humans are capable of thriving on very diverse foods. However, he did find one thing in common: they all ate some amount of fat-soluble, animal-derived vitamins. Even the near-vegetarian groups ate insects or small animals that were rich in these vitamins. He looked for, but did not find, a single group that was entirely vegetarian and had the teeth and health of the groups he described in 'Nutrition and Physical Degeneration'. There were three vitamins he found abundantly in the diets of healthy non-industrialized people: A, D, and an unknown substance he called 'activator X'. He considered them all to be synergistic and critical for proper mineral metabolism (tooth and bone formation and maintenance) and general health. He had a chemical test for activator X, but he didn't know its chemical structure and so it remained unidentified. He found activator X most abundantly in grass-fed butter (but not grain fed!), organ meats, shellfish, insects, and fish eggs. Many of these foods were fed preferentially to pregnant or reproductive-age women in the groups he studied. Price used extracts from grass-fed butter (activator X), in combination with high-vitamin cod liver oil (A and D), to prevent and reverse dental cavities in many of his patients. 'Nutrition and Physical Degeneration' contains X-rays of case studies showing re-calcification of severe cavities using this combination. After reading his book, I wasn't sure what to make of activator X. If it's so important, why hasn't it been identified in the 60+ years since he described it? I'm happy to say, it finally has. In the summer of 2007, Chris Masterjohn wrote an article for the Weston Price foundation website, in which he identified Weston Price's mystery vitamin: it's vitamin K2, specifically the MK-4 isoform (menatetrenone).It occurs exactly where Weston Price described it, and research is beginning to find that it's also critical for mineral metabolism, bone and tooth formation and maintenance. Its function is synergistic with vitamins A and D. To illustrate the point, where do A, D and K2 MK-4 all occur together in nature? Eggs and milk, the very foods that are designed to feed a growing animal. This is true from sea urchins to humans, confirming the ubiquitous and critical role of these nutrients. K2 has not yet been recognized as such by the mainstream, but it is every bit as important to health as A and D. The scientific cutting edge is beginning to catch on, however, due to some very tantalizing studies.In the next post, I'll go into more detail about K2, what the science is telling us and where to get it.
I left out one of the juicier tidbits from the last post because it was getting long. Investigators Kang-Jey Ho et al. wanted an explanation for why the Masai didn't have high serum cholesterol despite their high dietary cholesterol intake (up to 2,000 mg per day-- 6.7 times the US FDA recommended daily allowance).
They took 23 male Masai subjects aged 19 to 24 and divided them into two groups. The first group of 11 was the control group, which received a small amount of radioactive cholesterol in addition to a cholesterol-free diet that I will describe below. The second group of 12 was the experimental group, which they fed 2,000 mg cholesterol per day, a small amount of radioactive cholesterol as a tracer, and the exact same cholesterol-free diet as the control group. For the duration of the 24-week trial, the subjects ate the experimental diet exclusively. Here's what it was (in order of calories, descending): - Nondairy coffee creamer (made of corn syrup solids and vegetable oil)
- Beans
- Sugar
- Corn
- Corn oil
- A vitamin pill
Not a healthy diet by most peoples' standards, but those items are nevertheless widely eaten in the US. Over the course of the 24-week study, the investigators found no difference in serum cholesterol between the control and experimental groups. This isn't really surprising. The body has mechanisms for regulating blood cholesterol, and if you aren't eating any it just synthesizes more to stay at its preferred level.
The really interesting thing is that serum cholesterol increased dramatically in both groups. It went from 125 mg/100 mL to over 170 mg/100 mL, despite a large decrease in the saturated fat they were eating. The change took about two weeks to occur, and remained fairly stable for the remainder of the trial.
Both groups also gained weight. In the first week, they gained an average of 3 pounds each. To be fair, the initial gain was probably most water, which is what happens when a person increases their carbohydrate and salt intake. The investigators freaked out and cut their calorie intake by 400 kcal, only allowing them 3,600 kcal per day. Initially, they were voluntarily consuming 4,000 kcal per day. I find that interesting as well. Something tells me they weren't chugging non-dairy creamer because it was so delicious, but because their confused hormones were telling them to EAT.
Even after putting the subjects on calorie restriction (not letting them eat as much as they wanted, by an average of 400 kcal/day), they continued gaining weight. By the end of the study, the 23 subjects had gained an average of 7.8 lbs per person.
To summarize, this is what the investigators saw when they put 23 unfortunate Masai men on a bottom-rung industrially processed diet: elevated cholesterol, hyperphagia (excessive eating), and weight gain. Sounds familiar, doesn't it?
I've been digging deeper into the health of the Masai lately. A commenter on Chris's blog pointed me to a 1972 paper showing that the Masai have atherosclerosis, or hardening of the arteries. This interested me so I got my hands on the full text, along with a few others from the same time period. What I found is nothing short of fascinating. First, some background. Traditional Masai in Kenya and Tanzania are pastoralists, subsisting on fermented cow's milk, meat and blood, as well as traded food in modern times. They rarely eat fresh vegetables. Contrary to popular belief, they are a genetically diverse population, due to the custom of abducting women from neighboring tribes. Many of these tribes are agriculturalists. From Mann et al: "The genetic argument is worthless". This will be important to keep in mind as we interpret the data. At approximately 14 years old, Masai men are inducted into the warrior class, and are called Muran. For the next 15-20 years, tradition dictates that they eat a diet composed exclusively of cow's milk, meat and blood. Milk is the primary food. Masai cows are not like wimpy American cows, however. Their milk contains almost twice the fat of American cows, more protein, more cholesterol and less lactose. Thus, Muran eat an estimated 3,000 calories per day, 2/3 of which comes from fat. Here is the reference for all this. Milk fat is about 50% saturated. That means the Muran gets 33% of his calories from saturated fat. This population eats more saturated fat than any other I'm aware of. How's their cholesterol? Remarkably low. Their total serum cholesterol is about half the average American's. I haven't found any studies that broke it down further than total cholesterol. Their blood pressure is also low, and hypertension is rare. Overweight is practically nonexistent. Their electrocardiogram readings show no signs of heart disease. They have exceptionally good endurance, but their grip strength is significantly weaker than Americans of African descent. Two groups undertook autopsies of male Masai to look for artery disease. The first study, published in 1970, examined 10 males, 7 of which were over 40 years old. They found very little evidence of atherosclerosis, even in individuals over 60. The second study, which is often used as evidence against a high-fat diet, was much more thorough and far more interesting. Mann et al. autopsied 50 Masai men, aged 10 to 65. The single most represented age group was 50-59 years old, at 13 individuals. They found no evidence of myocardial infarction (heart attack) in any of the 50 hearts. What they did find, however, was coronary artery disease. Here's a figure showing the prevalence of "aortic fibrosis", a type of atherosclerotic lesion:
It looks almost binary, doesn't it? What could be causing the dramatic jump in atherosclerosis at age 40? Here's another figure, of total cholesterol (top) and "sudanophilia" (fatty streaks in the arteries, bottom). Note that the Muran period is superimposed (top). 
There appears to be a pattern here. Either the Masai men are eating nothing but milk, meat and blood and they're nearly free from atherosclerosis, or they're eating however they please and they have as much atherosclerosis as the average American. There doesn't seem to be much in between. Here's a quote from the paper that I found interesting:
We believe... that the Muran escapes some noxious dietary agent for a time. Obviously, this is neither animal fat nor cholesterol. The old and the young Masai do have access to such processed staples as flour, sugar, confections and shortenings through the Indian dukas scattered about Masailand. These foods could carry the hypothetical agent."
This may suggest that you can eat a wide variety of foods and be healthy, except industrial grain products (particularly white flour), sugar, industrial vegetable oil and other processed food. The Masai are just one more example of a group that's healthy when eating a traditional diet.
Why are we so soft today? Why is it that our ancestors were able to perform feats like killing bears and wooly mammoths in snow-swept grasslands? How do present-day tribesmen withstand days of ultra-cold temperatures in Northern Greenland and prolonged periods without water in scorching hot Kenyan deserts? Why is it that a century ago, children in the Swiss alps ran barefoot through ice-cold mountain streams on cold days, while now they get carpal tunnel syndrome playing video games? How did they do all this without succumbing to the chronic diseases that are so rampant today? I believe part of the answer lies in hormesis.
Hormesis is the process by which a mild or acute stressor increases resistance to other, more intense or chronic stressors. It can increase resistance to a variety of stresses, not only the one to which you are exposed.
It might sound like a foreign concept, but you're more familiar with it than you think. Exercise is a form of hormesis. It's a stress placed upon the body that increases resistance to a number of other stressors: physical exertion, cardiovascular disease, depression, diabetes, age-related cognitive decline, neurodegenerative disease, etc.
Intermittent fasting is one of the most promising forms of hormesis. It's consistent with the variable energy intake our hunter-gatherer ancestors probably experienced. As with some other forms of hormesis, it has broad-ranging effects on health and stress resistance. Alternate-day fasting, a version in which food is available for 24 hours ad libitum and then not available for the next 24 hours, increases mean lifespan in mice under some conditions without reducing calorie intake. It increases resistance to neurodegeneration, stroke, myocardial infarction, toxins, cancer and diabetes in rodents. It increases the expression of heat shock proteins and SIRT1, both implicated in general stress resistance. Basically, it makes them tougher all-around.
Although only a few studies have been performed in humans, IF looks promising for preventing or reversing diabetes, cardiovascular disease, overweight and possibly other health problems. It can also decrease fasting insulin and increase insulin sensitivity considerably. I fast for 24 hours, once a week. No calories, only water. It's not a form of caloric restriction, because I eat like horse the day after fasting. It's just a mild stressor that toughens my body to other stressors.
I also take cold showers. Here the scientific data are more sparse, but it has a long history of use as a form of "body hardening". I do it to increase my cold resistance by firing up my non-shivering thermogenesis. It seems to be working. It certainly wakes me up in the morning! Have you ever noticed how you can get into cold water and be surprisingly comfortable once you're used to it, even though you're practically naked and water is conducting heat away from your body 20 times faster than air would? That's probably your non-shivering thermogenesis kicking in.
There are probably many other ways to induce hormesis. Do any of you have techniques to share? By the way, hormesis is one of the central tenets of homeopathy. Solid principle, incorrect application. I'd be happy to sell anyone sugar pills for 50% less than his or her local homeopath is selling them. I promise mine are equally effective...
Soft living makes a soft body. Give it some controlled stress from time to time!
Thanks to Kirill Tropin for the CC photo.
Last night I was watching a little video clip of the Jack LaLanne show. LaLanne was an advocate of strength training and whole foods nutrition whose TV show ran from the 1950s through the 1980s. In the clip, he describes how his father died an early death due to heart and liver disease. A quote that really stuck with me was when he said his father died due to "disregarding nature's laws". That pretty much sums up my philosophy. Live in a way that generally mimics what our genes evolved to thrive on. Why did our paleolithic ancestors have strong, healthy bodies? Why are there still cultures that are free of chronic disease to this day, even into old age? Because they are following nature's laws. Break the law at your own risk. Jack LaLanne and I do differ a bit on what constitutes a natural diet. For example, I don't throw out my egg yolks... But hey, the man is 94 and going strong. Here's another quote of his: "If man made it, don't eat it". Words to live by. Quite literally.
One of the things I've been thinking about lately is the possibility that intestinal damage due to gluten grains (primarily wheat) contributes to the diseases of civilization by inhibiting the absorption of fat-soluble vitamins. If it were a contributing factor, we would expect to see a higher incidence of the common chronic diseases in newly-diagnosed celiac patients, who are often deficient in fat-soluble vitamins. We might also see a resolution of chronic disease in celiac patients who have been adhering faithfully to a long-term, gluten-free diet.
