Sunday, October 30, 2016

Popular diets



I long hesitated before I decided to write this article. The main reason is that I want to be a proponent, not a criticizing naysayer. And speaking about recent popular diets automatically turns into criticizing them.

However, it had to be done. When faced with questions like "do you think the xyz-diet is healthy" I keep repeating the same stuff over and over again, so... what's more practical than writing down everything and referring people to my blog?

So, here we go. A long post on what is good but also what is wrong in recent popular diets. Read it in sections.


Vegan


Don't get me wrong, I don't want to convert anybody into eating carcasses. I already mentioned elsewhere that I didn't invent the rules, I just know them and my role is only to inform, so don't blame me for being honest: blame evolution.

A vegan diet removes a priori every product that is animal in origin, including meat/fish/eggs/milk but also honey, leather, fur and cosmetics tested on animals. As vegans will tell you: it is more than a diet, it is a lifestyle.

The approach is clearly dogmatic, but I am not here to criticize that point of view, everybody has the right to follow the ethics they feel better for themselves. I am here to speak about nutrition as a science.

The most common critique that everybody makes to a vegan is:

Where do you get your proteins?
(imagine I said it in falsetto)

I will speak in favor so we settle this immediately: proteins are found everywhere!

Good plant-based sources of proteins (which I myself eat regularly and in quantities) are:
  • pulses (beans, chickpea, lentils, green peas, faves, ...)
  • nuts (almonds, cashew nuts, pecan, walnuts, hazelnuts, ...)
  • seeds (pumpkin seeds, chia seeds, hemp seeds, pine seeds, ...)
  • pseudo-grains (amaranth, quinoa, buckwheat, ...)
  • whole grains (rye, oat, ...)
  • ... and, to a lesser extent, in a number of other vegetables (asparagus for example)

The fear of being low in proteins (and the fact that humans have an hardwired taste for meat...) often brings vegans to eat the so called meat-replacements. Below is an incomplete list, just to give an idea:
  • soy products (tofu, soy-burgers, soy-milk, soy-yogurt, etc)
  • quorn (it comes in the form of sausages, pseudo-steaks, etc, ...)
  • spirulina

Let's see why I don't recommend them.

Soy

Contrary to popular belief (a belief enforced not by scientific evidence but instead by a hammering marketing campaign...), soy is not an healthy option.

This list of reasons kindly provided by the WAP Foundation should be enough to enlighten most readers:
  • High levels of phytic acid in soy reduce assimilation of calcium, magnesium, copper, iron and zinc. Phytic acid in soy is not neutralized by ordinary preparation methods such as soaking, sprouting and long, slow cooking. High phytate diets have caused growth problems in children.
  • Trypsin inhibitors in soy interfere with protein digestion and may cause pancreatic disorders. In test animals soy containing trypsin inhibitors caused stunted growth.
  • Soy phytoestrogens disrupt endocrine function and have the potential to cause infertility and to promote breast cancer in adult women.
  • Soy phytoestrogens are potent antithyroid agents that cause hypothyroidism and may cause thyroid cancer. In infants, consumption of soy formula has been linked to autoimmune thyroid disease.
  • Vitamin B12 analogs in soy are not absorbed and actually increase the body’s requirement for B12.
  • Soy foods increase the body’s requirement for vitamin D.
  • Fragile proteins are denatured during high temperature processing to make soy protein isolate and textured vegetable protein.
  • 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.
  • Soy foods contain high levels of aluminum which is toxic to the nervous system and the kidneys.

For those interested to read further about this topic, I recommend The list of myths and truths about soy, and for a long read The Ploy of Soy. You'll notice that some of these documents are older than 20 years and still topical, yet you probably never heard about them. What you heard in the last 20 years is the hammering marketing campaign.

Quorn

That's an intriguing one. Quorn is a meat-like substance made from textured proteins from a fungus (Fusarium venenatum).

A consistent number of people accuse reactions after eating quorn. Additionally, it has been introduced very recently and no traditional culture ever ate quorn before.

Is it safe at all? I don't have the answer yet... but considering what happened until now, every time a non-traditional food had been introduced and became mainstream, my take is that we will have some news soon or later.

Spirulina

Spirulina is a cyanobacterium (either Arthrospira platensis or Arthrospira maxima). used as a dietary supplement as well as a whole food. It is available in tablets, flakes and in powder form.

Dried spirulina contains in average 60% proteins. I underlined the word dried because often people make the comparison between 50 grams of dried spirulina and 50 grams of raw meat to prove that the first contains more proteins than a steak: this is an example of those situations where common sense falls apart and all what matters is proving one's credo, to the detriment of good science.

The reality is that, from a nutritional point of view, spirulina is no better than other sources of vegetable proteins, but is way more expensive for the consumer (again, the hammering marketing).

Let alone the price, spirulina has been shown to have a number of side effects:
  • Contains cyano-cobalamine (unsurprisingly, since it is a cyano-bacterium). This impairs the absorption of methyl-cobalamine. More details in the next paragraph.
  • Worsens phenylketonuria. Phenylketonuria is a genetically acquired disorder, wherethe patient cannot metabolize the amino acid called phenylalanine due to the lack of an enzyme named phenylalanine hydroxylase.
  • Spirulina boosts the activity levels of the immune system. Wait.. so it is good? Yes and no, actually... not for everbody: this poses a threat of drug interaction, especially with immune-suppressants. Spirulina and immune-suppressant drugs work in a contradictory manner.
  • Since it up-regulates the immune system, it also exacerbates the symptoms of autoimmune diseases.
  • Risk of heavy metal toxicity. Varieties of spirulina that are produced under unrestrained settings are often infested with significant traces of heavy metals, such as mercury, cadmium, arsenic and lead. The source matters.
  • Renal disorders. A large amount of ammonia is produced in the body as the protein in spirulina is metabolized (those who attended my live workshops know what I am speaking about: it's the bicycle experiment)
  • Digestive discomfort. Consuming spirulina can lead to synthesis of digestive gases in excess amount, causing abdominal cramps and flatulence.
  • Septic shocks. It is quite possible for spirulina to be infested with toxin-producing bacteria
  • Risk of acquiring Motor Neuron Disease (MND). Spirulina harvested from the unrestrained wild sources, such as lakes, ponds and sea are often toxic in nature.
  • Risk for pregnant women and breastfeeding infants. The side-effects of spirulina on the normal course of pregnancy are yet to be discovered.

The above list can be translate into English like this: as is the case of quorn and other recently introduced superfoods, spirulina still has a long way to go before it can be declared safe.

Last but not least, while I have never tasted it myself and probably never will... it doesn't even look appetizing. I'd rather have a beans salad instead.

Not only proteins

So, are we done? Of course no! Although essential, the body doesn't need only proteins to stay healthy. Here is a list of other nutrients that are essential for humans and which people on a extremely rigid vegan diet may be deficient in:
  • Retinol (Vit-A)
  • Cholecalciferol (Vit-D3)
  • Menaquinone (Vit-K2)
  • Methylcobalamine (Vit-B12)
  • Medium and long chain omega-3 fatty acids (EPA and DHA)
  • Iron
  • Calcium
  • Coenzime Q10 (CoQ10)
  • Carnitine (Vit-BT)
  • Creatine (Vit-B20)
  • Conjugated linoleic acid (CLA)

Retinol

Retinol is the only active form of Vitamin A, all other forms are called carotenoids and are to be considered precursors to the real Vitamin A.

The body has a limited ability to convert carotenoids into retinol, with the usual distribution where some people can convert enough of it to stay healthy, some hardly cover the needs and some others have an impaired conversion and cannot meet the requirements at all. Regardless your natural predisposition to efficiently make the conversion, it is indeed a vitamin that we have to introduce in our bodies through our diets.

The bad news for vegans is that retinol is only found in animal products, such as eggs, liver, dairy and oily fish. Whenever you are reading a blog that recommends carrots because they are rich in vitamin A... change your source of information.

Cholecalciferol

The preferred source is universally considered to be sun exposure. The Vitamin D3 is an hormone that our body produces from cholesterol in our skin whenever we suntan. Unfortunately, unless you live in the tropics, a year-long vitamin D3 coverage from sun exposure alone is impossible, and must therefore be provided  through the food we eat.

Contrary to popular belief, nuts and seeds are not a good source of the same, as they contain vitamin D2. Good sources of D3 are eggs, liver, dairy and oily fish. One notable exception is Cladonia arbuscula (a lichen, yummy...).

Menaquinone

Vitamin K2 is the third indispensable vitamin needed for calcium metabolism. Without it, the calcium absorbed in the intestine will not go into the bones, but instead calcify soft tissues (atherosclerosis).

Although many websites report that K2 is only found in animal fats, this is not true. This vitamin is produced by bacteria through lacto-acid fermentation. A minimal amount can be synthesized directly in your large intestine by friendly bacteria. Vegetable sources of K2 are:
  • lacto-fermented pickles
  • natto... Yes, it's soy. However, fermented soy has less side effects. Alternatively: learn to prepare homemade natto from chickpeas (it's easier than you think)

Methylcobalamine

This is the most famous critique against vegan diets. It is so true than vegans themselves acknowledge it and supplement accordingly. I won't develop this topic further if not to make a clear distinction between two forms of cobalamine:
  • methyl-cobalamine (what our body actually needs)
  • ciano-cobalamine (a look-alike of the true B12 that doesn't have the same metabolic functions)

Some plants and algae, and the above mentioned spirulina, contain cyano-cobalamine: they are not a source of B12.

Many supplements contain ciano-cobalamine instead of methyl-cobalamine. If you choose to supplement, do it wisely.

Omega-3

That's another topic where is a lot of confusion about. I already mentioned it in other posts, but it is worth repeating:
  • ALA is the short-chain omega-3 fatty acid that is essential for humans (we cannot manufacture it from scratch or from other fats)
  • humans can indeed convert ALA into DHA and EPA (medium and long chain omega-3 fatty acids)
  • however, like it happens with Vitamin A, the conversion is extremely inefficient and for the majority of people it doesn't cover the essential needs, making these two important fats conditionally essential. In old people, for example, this conversion is very low.
  • as a consequence, it is extremely important to introduce these two with our diets

There is a catch... DHA and EPA are only contained in animal products, ALA being the omega-3 fat contained in plants like chia, flax and hemp. A notable exception is a GMO breed of the plant Camelina which had been recently engineered to produce DHA and EPA.

Once again, it is important to be well informed, and most people are really badly informed: vegetable oils are touted as sources of omega-3, but their fatty acids profile is not complete. This may leave some individuals who opt for a strict vegan diet, with severe deficiencies. This is particularly true for growing children and elderlies: the brain needs omega-3 fatty acids.

Iron

Iron is better absorbed in the intestine when it is in heme form, which is the form of iron found in animals.

However, Vitamin C greatly improves the absorption of iron, and a vegan diet eating plenty of fresh vegetables and fruits is particularly rich in this very vitamin, so these two facts may balance themselves.

On the other side, calcium and iron compete for absorption: a meal containing the two may reduce iron intake. Yes, nutrition is complicated...

Calcium

Badly driven studies came to the conclusion that milk causes osteoporosis. This is total non-sense and will be discussed in a dedicated post which I will do with the aid of a person better qualified than me to speak about milk (stay tuned).

Other myths and legends claim that broccoli have a higher calcium content and are therefore a better source of this mineral. I will add something to this: limestone contains even more calcium, does this undeniable fact make calcareous rocks the ultimate calcium supplement? Obviously no, there is again some confusion between the presence of a nutrient in a food, its absorption and its bio-availability in metabolic processes. Guess what you need to absorb and use calcium? Vitamins A, D3 and K2, none of them are found in broccoli (or limestone) but are present in the correct proportions in milk.

It is not that you can't absorb and use calcium from broccoli (or limestone), just make sure you meet your requirements of fat soluble vitamins through other sources of through supplementation.

Coenzime Q10, carnitine, creatine, CLA...

These micronutrients, and many others I didn't mention, are not essential vitamins. In the sense that our body can often produce enough of them. They are also found in vegetables, although in small quantities.

Nonetheless, studies showed that introducing them through diet, and so removing the burden of producing them from our body, has a number of health benefits.

Conclusion: can you be healthy on a vegan diet?

My favorite answer to this question is:

You can be healthy despite (and not thanks to) a vegan diet

This usually upsets my interlocutors with heterogeneous reactions, including unfriending me from Facebook. Had she decided to stay for the second part of the answer, she would have discovered what follows:
  • you can be healthier that most people who are eating junk food, and this is no brainer: every diet is better than a junk-centric diet
  • however, lack of disease is not synonym of thriving: a well balanced omnivorous diet will always top a well balanced vegan diet
  • according to your biochemical individuality, make sure you are eating enough proteins. Don't listen to the irresponsible guru telling you that proteins are dispensable. As we saw, meeting the requirements is totally possible with a vegan diet
  • don't fall into the trap of pre-packaged "healthy" vegan meals and snacks. Prepare your recipes from the bare ingredients and enjoy total control over what you eat
  • some micro-nutrients cannot be found in a 100% plant-based diet, make sure you supplement accordingly for the required ones
  • in any case, always listen to your body. Don't lie to yourself just to follow a dogmatic dietary approach and even more important: don't do it in order not to disappoint the rest of the tribe. When it doesn't work, it doesn't work.

What lessons can we learn from a vegan diet?

All diets, despite many differences, agree on this one thing: we should eat more fresh vegetables, and a well balanced vegan diet makes vegetables the staple.

Although I am omnivorous, I regularly read vegan websites and forums to learn some tricks, I believe it is important to always maximize the nutrient density of what we eat and ideally we should try to get the best of the two worlds.

Another no less important lesson regards animal welfare and ethical treatment of animals.


Vegetarian (eggs and dairy)


This is according to science (so not in my opinion) the minimal set of food required for proper health and possibly even for thriving.

Following everything I said for the vegan diet, a vegetarian diet adds:
  • Eggs, source of Vit-A, D3, K2, B6, B12, DHA/EPA, iron
  • Milk, souce of Vit-A, D3, K2, CLA and calcium

Conclusions: can you be healthy on a ovo-lacto-vegetarian diet?

Definitely yes, although there is still the risk for some individuals to be low in essential fatty acids.

The source is also very important: milk from grass-fed cows and eggs for cricket-fed chicken have a vastly superior nutritional content than grain-fed cows and chickens. As a consumer, you have the ability to make the change happen: it is the demand that drives the offer, not the other way around.


Ovo-lacto-pesco-vegetarian


This is obviously even better than a standard vegetarian diet, with the inconvenient that, yes... this time we are indeed killing animals to get our food.

What makes a pesco-vegetarian diet so interesting?
  • Fish is the ultimate source of medium and long chain omega-3 fatty acids, together with liposoluble vitamins A, D3, K2
  • If you opt for small fish you can easily eat their soft bones (a source of calcium).
  • Fish also contains good quantities of B12, zinc and iron.

If your concerns are just ethical, you should consider eating seashells. Those animals lack a central nervous system and technically they are "plants made of flesh". Oysters in particular are very rich in B12, omega-3, iron and zinc. Something to think about.

Conclusions: can you be healthy on a ovo-lacto-pesco-vegetarian diet?

Several traditional cultures have been thriving on this very diet for millennia, so the answer is obviously yes.

Same observations as for the ovo-lacto-pesco-vegetarian diet: choose local and organic produce, or wild caught fish. Again, this is not what the supermarkets want to propose you, but you as a consumer can make the difference.

Trivia

Anybody noticed that ovo-lacto-pesco-vegetarian-diet is just a tongue-twister to say Mediterranean Diet?


Paleo


A-ha... I'll be lucky if I still have friends at the end of this paragraph.

The Paleo Diet is another dogmatic diet. It is basically an elimination diet which discourages eating the food from the agricultural revolution, namely: grains, pulses, refined sugar, vegetable oils and dairy. A lot of emphasis is put on in-season fresh vegetables and fruits from local produce and organic meat, eggs and fish.

Although dogmatic, the idea works! People on a well balanced paleo diet indeed thrive and a considerable number of testimonials confirm having resolved health issues such as:
  • obesity (some before/after pictures are simply jaw-dropping)
  • irritable bowel syndrome
  • metabolic syndrome
  • allergies
  • skin rashes, eczema
  • ... just to name a few

In short, while not being paleo myself, I admit that among the recent diets, this is probably one of the most sound. However, as usual, you can also do it the wrong way, let's see why: typical errors of paleo diet adopters.

Packaged food

The Paleo Diet has recently become a major trend, you can easily tell it not only because every magazine, television shows and "that guy at the gym" talk about it, but also because there are more and more "paleo approved" packaged food offers. I won't develop this point any further, anybody able to understand my point doesn't need me to explain it. Those unable won't get it anyway.

Bacon (and muscle meat in general)

One of the favorite food of paleodieters is bacon.
  • Tasty? Yes, only a fool would disagree.
  • Unhealthy? No, despite what they told us over 30 years ago.
  • Healthy? Neither! Cured meat is not a healthy food. Bacon should be considered an innocent but occasional treat, not the base of the new pyramid!

Muscle meat is another staple of many of those doing the paleo diet the wrong way. The muscle is the animal cut with the higher content of proteins per weight. However there is an imbalance between two amino-acids: methionine and glycine.

Excess of methionine depletes the stores of Vit-B6 and Vit-B12 and may raise the levels of homocysteine in the blood (and inflammatory amino-acid) whose high levels represent a risk for heart disease. Ironically, high homocysteine levels is also a common condition amongst vegans and vegetarians.

Glycine is found in connective tissues like skin, tendons, ligaments, in bone broth and internal organs. Internal organs are also the most nutrient-dense part of the body: they may have less proteins per weight but are rich in vitamins and minerals.

Think like a real caveman: you ran 10 miles to chase down a 1 ton aurochs... don't get just the filet and throw the rest: eat nose to tail.

Replacements

Like it happens for vegans and vegetarians, it is sometimes difficult to abandon overnight some commodity foods you have been eating for a lifetime to go back to what real cavemen actually ate: enter replacements. For the paleo diet this usually involves substitutes to the forbidden wheat flour and milk. I already expressed here my concerns.

Treats

Another source of bad information are the recipe blogs animated by paleo enthusiasts, 99% of the time they are people with no clue what nutrition is about. A considerable part of their recipe sections is dedicated to paleo-approved cakes, biscuits, spreads, semi-freddos, and so on.

With all those sweets, I think we finally discovered the reason why cavemen died at such a young age!

Ok seriously now: dear Jane, dear Joe... you can't live of treats, no matter how paleo they are. Eat Real Food.

The weakness of the dogmatic approach

The dogmatic approach of removing agricultural food (cereals, pulses and dairy), misses one important detail: while it's true that you can live without, most of these food are healthy and nutritious when properly prepared. And that will be the topic of my next post.

Low-carb paleo

Check the dedicated paragraph, below.

Conclusions: can you be healthy on a Paleo Diet?

Yes, provided you are on a genuine paleo diet, not on some grotesque version of it dominated by fried bacon, coconut milk, almond muffins, almond crust pizza and paleo-approved treats.

What lessons can we learn from the Paleo Diet?

In my personal opinion, the merit of paleo has been to courageously challenge the established common wisdom on the following myths:
  • that grains are to be considered the staple of human diet
  • that fats are unhealthy: the less, the better
  • that meat, and in particular red meat, is unhealthy
  • indirectly, it exposed the problems of the current ways of preparing cereals, pulses and dairy


Primal


Some people choose a more relaxed version of the paleo diet, which includes dairy products, preferably grass-fed, full-fat and raw.

Once you get rid of the pre-concept that milk is bad for you (hint: skimmed, homogenized and pasteurized milk is bad for you), and embrace the studies of Weston A. Price who reported that among primitive cultures, those enjoying superior health where those which introduced dairy in their diet... it makes totally sense for me to conclude that everything good (and bad) I said about the paleo diet can be re-confirmed for the primal diet.

Conclusions: can you be healthy on a primal diet?

Definitely yes. If milk is tolerated it can even be healthier than the paleo.

Same risks of doing it the wrong way, thus...


Low-carb-high-fat


I already exposed the advantages and dangers of low-carb diets in a previous article.

LCHF diets such as the Atkins, Dukan and some interpretations of the paleo diet are becoming more and more popular and for a reason: people are extremely pissed-off because of the demential advice that we had been sold for the last four decades: to reduce fats to the minimum and draw a uniform block of starches at the base of the infamous food pyramid.

The discovery that fats don't make you fat (sugars do) had been an epiphany for a lot of people, with two major currents forming:
  • those who got it right and eliminated refined sugars, while adding healthy fats and proteins in their diet
  • those who bought the idea that being in ketosis is the natural state for humans, reduced their carbohydrates intake below the mythical 50g per day and keep testing their urines 10 times per day to make sure they stay in ketosis

Ke... keto... say whaaat?

Ketosis

Ketosis (not to be confused with ketoacidosis) is a metabolic state in which some of the body's energy supply comes from ketone bodies in the blood, in contrast to a state of glycolysis in which blood glucose provides most of the energy. Ketone bodies are produced by the metabolism of fats.

English translation: you use fat for energy.

Does it work for weight-loss? You bet it does! Once again, plenty of people experienced stunning results, with before-&-after pictures to witness them.

Is it healthy in the long run? That's another story. While it is common sense that we had been eating too many carbohydrates, moderation should drive our choices. I explained already how the food we eat are messages we send to our body, so if you still are not convinced just refer to my previous article.

Ketosis is an important therapeutic protocol for epilepsy, diabetes and it is proving its validity to support cancer therapy. Healthy people can experience benefits, but also drawbacks.

Conclusions: can you be healthy on a LCHF diet?

I am more prone to recommend an individualized carb diet:
  • those who are very active need more (forget the fat-burning-beast market claim)
  • people not moving a single finger throughout the day, need less
  • patients trying to lose weight or with blood sugar imbalances could benefit eating less
  • those with adrenal exhaustion definitely need to modulate carbs intake (in particular fast sugars): not too much, not too little... funny enough the reason for both is the same: avoid hypoglycemia
  • people with non-autoimmune forms of hypothyroidism should not attempt a low-carb diet (hint: fix the adrenals first)


Low-fat


Could I forget to mention the low-fat diet?

As strange as it seems, and despite the huge body of evidence that fats are good for you, I still meet people with 0.001% yogurt in their baskets, at the supermarket.

As I said in a couple of old posts ([1], [2]), a consistent quantity of good quality fats should be eaten regularly for optimal health.

Conclusions: can you be healthy on a low-fat diet?

I think evidence speaks for herself. Decades of low-fat craze left us sicker than ever before in human history.


Caloric restriction diets


My professor once said:

Eat less and move more... if only it were that easy!
We would have solved the issue 40 years ago!

And, as usual, he was right.

Caloric restriction diets are always in fashion, the reason for it is obvious and I should not even mention why. And the reason is (just in case): in order to take from the reserves, you need to create an imbalance between what you eat and what you burn. This is thermodynamics, so far so good.

There are therefore two possible paths:
  • eat less than you burn
  • burn more than you eat

Eat less

We all agree that overeating is not a friend of weight loss. What about undereating?

Nutrition is not only about calories, proteins, carbohydrates and fats. Nutrition is also about minerals, vitamins and all the plethora of other micronutrients that are found in real food. The first and most dangerous risk of following a low-calories diet, especially for long periods, is being undernourished, in the sense of being unable to meet the recommended intake of micronutrients.

I already explained why making-up with supplements is not a good idea, so I'll just refer to my previous article.

Eating less also slows down the basal metabolism, causes muscle loss and in the long term may down-regulate the thyroid (and so permanent weight gain).

My recommendation:

Move burn more!

Yes, the secret is not to move more, but to burn more.

If these two seem synonyms, it is not your fault. One again you have to blame the hammering marketing of a fitness industry that for 40 years transformed all of us into some kind or mindless chronic cardio addicted. Yes, I've been in that hell, too.

Why it doesn't work? Chronic cardio only burns while you are doing it, so you need to do plenty of it for burning a lot of calories. However, long cardio sessions cause chronic low-grade inflammation, which stimulates the production of cortisol (a catabolic hormone) which causes muscle loss and water retention. Long sessions also stimulate appetite, often more that what you burned.

Weightlifting or bodyweight strength training exercises, instead, have the advantage to raise the basal metabolism (so you burn more throughout the day, even when you are sleeping). It is also the kind of training that triggers the production of testosterone (an anabolic hormone) which in turn causes muscle gain. More muscles: more calories burnt. Short sessions stimulate the appetite, but much less than long ones: I regularly find myself eating less than I should, even after an intense - but short - workout.


Gluten free


This is an interesting one. Worth spending some words.

Gluten is a generic name for a family of proteins found in cereals, in particular wheat. They are responsible for providing the characteristic mechanical properties of a dough when it is kneaded and that's what allows to make a loaf with big holes. Gluten is also a very controversial ingredient in people's diet.

Celiac disease

Celiac disease is an auto-immune condition characterised by a genetic predisposed allergic reaction to gluten, in the small intestine.

Celiac disease is real and can be tested. The estimated incidence on the population is 0.5-1% in developed countries. If you are reading this blog I assume you are in a developed country.

For people with celiac disease, going gluten free is a must to avoid serious complications.

Non Celiac Gluten Sensitivity

What about the other 99%?

It has been proposed that a condition called non-celiac gluten sensitivity is present in a large percentage of the population. Symptoms can range from GI discomfort to fatigue and other neurological issues.

The existence of NCGS would explain the benefits shown by those who went gluten-free (in particular paleo-diet adopters) and although they are often mocked that "their sensitivity is all in their head", blood tests don't lie: for some people going gluten-free really provided health benefits.

But was it the gluten? Or is there something else in wheat or in the subjects themselves that can trigger those symptoms?

According to me (when my take is not ultimately supported by current science I'll always say it): gluten free is not a fad, but not perforce because gluten is being removed. Let's see why I think this:
  • Today's wheat is not the wheat we used to eat 100 years ago. It is indeed richer in gluten and not only: a stronger type of gluten. Often gluten sensitivity disappears when people try other types of cereals such as rye.
  • Today's bakery products do not follow the traditions. Again, gluten sensitivity disappears when people start eating homemade sourdough.
  • The reaction may be to other substances contained in wheat, both natural and artificial (pesticides and herbicides for example).
  • People with NCGS also happen to have leaky gut, a condition where partially undigested proteins may leak through the small intestine directly into the blood stream. Is it a coincidence that those with NCGS are also sensitive to milk, eggs or even coffee? If this is the case, removing gluten is like an ostrich hiding its head in the sand. The root cause is a highly permeable gut that lets everything go through, THAT should be the NUMBER ONE priority! In this case, a good holistic nutritionist can help.
  • Well... I may indeed be in your head! How many people are ssso gluten sensitive, but once in a while binge on white bread because "it comes and go, this week it's fine"? Or can eat seitan because they don't know it is pure gluten?

Last but not least, I don't trust very much recent researches. There is a huge interest in convincing people that gluten is the ultimate villain in order to sell expensive gluten-free products and bread replacements to self-diagnosed gluten-sensitive consumers. The following list is an example of ailments, diseases and conditions attributed to gluten:
  • Irritable bowel syndrome
  • Fibromyalgia
  • Dermatitis and other skin conditions
  • Multiple sclerosis
  • Peripheral neuropathy, myopathy, and other neurological disorders
  • Schizophrenia
  • Depression
  • Attention deficit hyperactivity disorder
  • Ataxia
  • Type 1 diabetes
  • Autism spectrum disorders
  • Ménière disease
  • Endometriosis
  • Insulin resistance and inflammation
  • ... being obnoxious at social events (this is mine)

When there are too many heterogeneous conditions associated to one single food group or (like in this case) a single molecule... I am always very skeptic.

Conclusions: is gluten free a fad or not?

My personal opinion: yes and no.

It is totally possible to live without pasta, bread, pizza, biscuits, grissini, bruschetta or morning cereals. I even recommend to try ditching grains and derivates to see how your body responds. Just don't fall into the trap of comic bread replacements.

However, concerns about gluten are overly amplified for the marketing reasons I mentioned before, so in the end the ultimate judge whether or not it is a fad is you, and your personal investigations.

Also try the traditional methods for preparing cereals: if in doubt just stay tuned because I will soon speak about this.

If you suspect NCGS, try getting an appointment with a good holistic nutritionist or naturopath. It may be leaky gut.

Finally: listen to your body, not to bloggers (not even to me).


Intermittent Fasting


Intermittent Fasting is another protocol which is getting more and more popularity. There are several formulas, but the most common is: two meals per day (lunch and dinner) followed by a 16 hours fast.

It work pretty well for weight loss and for muscle gain for tree reasons:
  • people instinctively eat less (so it is a calories restriction diet)
  • in the last hours of the fasting phase, the subject may be in a mild ketosis (so fat burning mode)
  • endogenous somatotrope hormone (HGH, Human Growth Hormone)

Human Growth Hormone
Usually, doing a short but intense workout at the 15th hour, before breaking the fast, stimulates the release of HGH. This hormone serves two roles:
  • breaking down fats for energy
  • it is an anabolic hormone, and it is 100% natural

English translation: you burn fat and you build muscle.

Again, I am not saying it doesn't work. Hundreds of photo galleries show the impressive gains of intermittent fasters.

I may be wrong but in my opinion it is not safe in the long run: fasting is part of our genetic heritage, but alerting the adrenals on a daily basis with low-glycemic events means messing-up one's endocrine system. For what? A six-pack?

Use with care, like any other diet...


Final words


Yes, this time it was a very long article, and it was not even complete. I haven't mentioned diets such as:
  • blood type diet
  • chrono diet
  • raw-foodism
  • the volumetric diet (eat tons of fiber and water-containing food)
  • diets based on multi-marketing products
  • ... breatharianism

These are undeniably fad diets or scams. In my post I decided to cover only the most popular, exposing what are their advantages, their weaknesses and their potential risks.

For all the rest there are other websites that did some excellent analysis already (http://www.quackwatch.com)

Eat well, and stay tuned!

Wednesday, August 10, 2016

On supplements


I am often asked what, as an holistic nutritionist, my position on supplements is.

The topic is quite complex and I cannot reply with a simple “yes their good”, “no their not”. What makes nutrition a very fascinating science is that the answer is always “it depends”.

This is not what people want to hear so chances are that half of the readers will stop reading NOW and look for another blogger who dispenses a more manicheistic opinion. But if you made it to this sentence thanks for your confidence, let me explain.

The correct way to supplement


Supplements are indeed useful in certain circumstances, Even I myself prescribe supplements to resolve some important deficiencies. Some fundamental things to consider are:
  • nobody has the same needs. The recommendation to swallow multivitamin pills like candies is based on the desperate need to sell medicaments to people that wouldn’t otherwise fund Big Pharma
  • supplements are meant to unlock tricky situations where diet alone cannot help. These cases must be identified correctly with the help of a registered dietician or nutritionist (and not by the pharmacist whose main interest is to sell you something)
  • supplements are a temporary solution, not a daily habit to keep all your life in the hope to make to 100yo

Let’s take for example the group of vitamins B:
  • some people may need more vitamins B of this group: (B1, B4, B6, B12)
  • others may require a second group of vitamins B, formerly called vitamins G (B2, B3, B8, B9, choline betaine, lipotropic factors)
The typical multivitamin just tries to provide a good amount of all the vitamins based on the daily recommended values, this obviously cannot work for everybody and to some people this unbalance may even exacerbate their issues. Would you walk in somebody else's shoes? Of course you can give it a try but I am pretty sure it won’t feel good.

Properly prescribed supplements, on the other hand, can be helpful to unlock tricky situations. One typical example I mention is the condition related to low gastric juices' acidity, with all the cascade of issues that this represents:
  • GERD (yes: Gastroesophageal Reflux is caused by lack of acids, not excess of them)
  • bloating
  • SIBO (Small Intestine Bacterial Overgrowth)
  • leaky gut (and so allergies and food sensitivities)
  • and last but not least, impaired nutrients absorption

The last one is important: in order to produce stomach acids the body needs a number of nutrients, one of these is zinc. The irony is that to be able to absorb zinc you need stomach acids. It is a vicious circle and clearly diet alone cannot fix this, supplementation with zinc, digestive enzymes and additional acids is required. And that’s just ONE example, it should start to be clear why do-it-yourself diets don't work.

Then, why not taking supplements all our life anyway?


A-ha… I see where you come from: you want skip the boring healthy food and try to make up for the missing nutrients with pills and fortified snacks. Nutrients need cofactors to be properly absorbed and used in metabolic processes. Some are more famous than others (Vit-C and iron, Vit-A-D3-K2 and calcium, …). Others are less obvious, one example for all.

Ascorbic Acid is a molecule that the FDA decided to call Vitamin C. It is a very important nutrient for our body and although everybody thinks its role is just to calm the symptoms of a flu, its deficiency causes much worse conditions: bleeding gums, epistaxis, poor collagen health (and so weak cartilages, wrinkles…), poor adrenal glands function, etc. It was therefore decided a minimum quantity, called RDA, that everybody should take in order to avoid health complications, and so far so good.

Small problem now: ascorbic acid needs co-factors to be used in metabolic processes. These cofactors are a countless plethora of phytonutrients contained in the plants that naturally contain ascorbic acid itself and are definitely not found in a supplement. If you overdo with isolated ascorbic acid, and especially in the ambit of a poor diet, you can deplete your body’s stores of cofactors, with the consequence that, even in presence of ascorbic acid, you can show symptoms of Vit-C deficiency. How cool's that?

Reality check: the true Vitamin C is not ascorbic acid, but instead ascorbic acid with all its co-factors.

To conclude, the perfect supplement for Vitamin C (ascorbic acid and co-factors) are fresh fruits and vegetables. This holds true for most other nutrients:
  • Vit-A (it needs carotenoids to be used in metabolic processes)
  • Vit-B12 (like zinc, it needs good levels of stomach acids to be absorbed later in the small intestine)
  • Vit-D3 (must be in balance with Vit-A and Vit-K2), never take isolated D3 supplements, take fish oil instead
  • Vit-E (l-alpha-tocopherol is one molecule among many others with similar and complementary functions, most multivitamins contain only this one)

Quality of the supplements


Another issue with supplements is the quality of nutrients contained. I’ll go quick on this paragraph:
  • Vit-D3 (cholecalciferol) is often replaced by Vit-D2 (ergocalciferol)
  • Vit-B12 (methil-cobalamine) is almost always replaced by ciano-cobalamine
  • Vit-K2 (menaquinone) is rarely found in supplements, what you'll find instead is Vit-K1 (phylloquinone). Both are important, but are not interchangeable
  • And finally, vitamins produced per synthesis may present the rests of the solvents used in the production process (yummy...) 

Good supplements exist indeed, they are extracted from plants or from the organs of animals (glandular therapy). They contain the good vitamins and possibly even some cofactors, however they are more expensive: wouldn’t it be a better idea to invest that money in organic food?

Not only micronutrients


Protein powders, BCAA and multivitamins are the heritage of a “gym diet” that was very popular in the 80ies and 90ies. Bodybuilders supplemented for various reasons:
  • because of the wrong idea that the more proteins one eats, the bulkier they will get
  • because their low-fat diet, rich in refined carbs and lean meat (white rice, eggs white, chicken breast), left them seriously deficient in most vitamins and minerals

The “gym diet” recently lost some terrain thanks to the growing awareness of people on the importance of seasonal local produce and nutrient-dense food. Unfortunately some experts are trying to reintroduce them back, often for personal gain: either they have their own gamma of supplemental products or are planning to release it soon. I won’t point the finger: I’ll let you, the reader, the pleasure to rethink the claims of nutrition experts in this new optic.

Superfoods


Another trend are the superfoods, at least these are natural. Every year a new product is launched onto the market with a list of alleged health benefits. I’ll go quick on this one because I consider it the least of the problems: I myself enjoy goji berries sometimes, but not because I believe they have some magical properties. It's because I like them, and blueberries are not available all year long.

Typical characteristics of superfoods are:
  • they are newly discovered, often coming from some exotic location
  • consequently, none of your ancestors ever heard about them but in spite of this they did pretty fine (if you are here...)
  • sometimes they have some intriguing story behind: the monk who lived of goji for example, or the grain found in a hidden chamber inside a pyramid which had been planted and miraculously sprouted… c’mon give me a break!
  • it is cheap to produce but overly expensive for you to buy. Ah, the power of marketing!
  • for some reasons I never understood, they can grow at any latitude and altitude but you still have to import them
  • you are likely to forget about it after some years (mangosteen juice anyone?)

Conclusion


To be clear, I don’t think I walk on waters, but I am pretty sure I can swim better than many experts out there.

These days, with the help of internet and social platforms, the trend is the promotion of quick solutions to achieve health or higher performances (weight loss, clear skin, immune system strengthening, athletic performances, mental clarity, etc).

People don’t want to be sick and I can definitely understand it, that’s why I am so strict on my diet of nutrient-dense properly grown and prepared whole food. Eating liver is not very popular and most people would prefer a combo hotdog/multivitamin instead. The second option may still be better than hotdog alone, but in the optic of what we discussed this would limit your ability to fully express your genetic potential so… why?

In health, stay tuned!

Sunday, May 29, 2016

Six pack is the new black



Why is there a picture of the latest Tarzan in blog?

I was looking at the trailers of this movie (which I think I’ll go see by the way) and stumbled upon a series of articles about the draconian program that the actor underwent in order to get in shape for the role.

Four months of chicken breast and crunches… in short, the old school: low-fat/high-protein and no-pain-no-gain. The actor also mentions that one day he started crying and the nutritionist that was following him opted for an emergency cheat day.

I am not surprised, but I am also a bit perplexed.

Not surprised because: put me on a low-fat diet and ask me to exercise more than 45 minutes just for one day and I would start crying myself: ok for the exercise part, but I’d rather fast than eating tasteless food, as you probably noticed in the picture section of my Facebook account “Alex The Foodie”.

Perplexed because: I think it is pretty much clear to everybody that this paradigm never really worked if not in the short term, which is what the actor was looking for anyway: get an 8-pack quickly and stay fit for the time needed to make the filming.

I personally think it is a very wrong approach and, at the risk of making this article a celebration of my own life-style, I believe that some words must be said. Summer is quickly approaching and I expect a lot of males ready to do anything to exhibit a 8-pack at the beach (some would be happy with a 4-pack).

Now. The actor is almost my age, we also share the same name, so… nice abs Alex! I am not going to say that the result was not worth the effort: I am saying that the same result could have been achieved without even trying, just using a different approach.

The diet

As a certified Nutritional Therapy Consultant, I’d like to focus on the part “without trying”, this is my favourite aspect of the diet I follow and advocate, which is (sorry for being repetitive) a properly prepared whole food based nutrient-dense diet which follows the traditions.

Traditions from all the world, without exceptions, made use of animal fats, they included raw and cooked vegetables, didn’t know what the word refined meant but knew how to process the food in order to optimise the nutrient absorption (soaking, sprouting, fermenting). And had what I consider the ultimate nutritional element that every recipe should contain: taste.

This is where the tarzan-diet fails in my opinion: if punishing oneself and allowing an occasional binge-cheat day with pizza and tiramisu is not sustainable for as short as 4 months to an actor who is being paid to do it, why should it work for the average Joe? Then, what happens when you decide not to follow it anymore? Exactly, you become fatter than before, the well known yo-yo effect.

But there is more, and it goes beyond aesthetics. I don’t yet have enough details on the diet, however, if the nutritionist that followed Tarzan wanted to have some credibility beyond the successful weight loss achievements, he must have realised that his client was starving to death, and I am not speaking about calories, but nutrients: minerals, vitamins and essential fatty acids. These are found in real food, and humans, especially those exercising hard, have increased requirements of them.

Which is what the chicken diet doesn’t provide: one theory about the extinction of the Neanderthals proposes that they died of malnutrition when mammoths disappeared and they started eating rabbit and other smaller game. Lack of essential nutrients means a weaker immune system and infertility, all the conditions to become endangered: if your ancestors ate fatty meat for millennia and you suddenly switch to low-fat or vegan, you can’t expect to thrive as a species. Think the panda, an animal that is still physiologically and metabolically a carnivorous but eats bamboo shots…

In short, the nutritionist has probably also prescribed supplements, I think this is not sustainable in the long term neither: synthetic vitamins are not the same as the real stuff. They can be useful to temporarily solve an emergency situation, but not as a replacement of a well-balanced diet.

I'll come back again on the details of my diet, so far I always spoke in general and never published many recipes or a complete meal plan.

The workout

As for the exercise part, this is another interesting one: while it is true that I don’t exercise much in terms of time, those 30-45 minutes I do every day are quite tough.

One thing I can say already: I haven’t done a single crunch in the last 4½ years, yet my core has never been that strong.


The autor of this blog, on April 2016
(but pretty much the same any time of the year)


I haven’t done curls or lateral raises neither, and of course I didn't use machines.

As a MovNat Certified Trainer and Animal Flow Certified Trainer, I disregarded any exercise that works muscles in isolation, and concentrated instead on primitive movement patterns like crawling, balancing, walking, running, jumping, climbing and the occasional swimming session.

Which, if you think, is what a real life Tarzan would have done all his entire life... there are no treadmills, rowing machines, kettlebells or barbells in the jungle and the last thing I think when I see a liana is doing double-unders. Instead, there are obstacles: and in order to go forward you need to swim across a river, crawl under branches, balance on fallen trees, walk on uneven terrains while avoiding hazards, run from predators (or to preys), jumping obviously and climbing for sure. The Tarzan yell is optional.

I am not a proponent of exercising in Nature for everybody, I myself like controlled environments: the natural setting can be interesting, a real challenge that can be thrown in occasionally. But the focus must be on the human body and this is always with us, whether we exercise in a gym, in a city park or even at home. The best we can do, which I grant you is pretty much enough, is to reproduce these very movements and keep challenging ourselves by altering the volume, the intensity and the complexity of the exercises. And have fun in the process, if the workout is not fun, you’ll always find an excuse not to do it and will end up bingeing on pizza and tiramisu.

Conclusion

A nutrient-dense diet and a tough but playful program of exercises that honour our generic heritage is all we need to get/stay in shape and do it while maintaining or becoming healthy.

While Tarzan is clearly a fictional character, fortunately there are still few isolated groups of people eating and moving like our primitive ancestors did: they don’t binge on chicken cutlets, powdered whey and BCAAs, they are clearly not vegan and they would look at you amused if they saw you performing crunches or wasting hours on the elliptical trainer. They are here to witness that, either with a perizoma or in suit and tie, we are humans. The more our lifestyles vary from what our genetic code expects, the worst we will do.

Stay tuned, like the Facebook page of my Movement Factor Geneva and… don't forget to crawl.

Friday, April 29, 2016

Low-carb for life?


It's been long since my last article. A big thanks to all the people that kept reading and sharing my blog during the last months. The statistics are clear: I received an average of 50 visits per week from all over the world including countries I never intended to reach, which is not bad at all for a blog that hasn't been updated for 6 months! This makes me really motivated to restart writing.

Today I stumbled upon this article on the benefits of a low-carb lifestyle, with particular reference to high-performance training while in ketosis.

Low-carb diets live periodical periods of popularity, sometimes longer sometimes shorter. They seem to be very in vogue these days and many people are going low-carb or even zero-carb, often following the recommendations of a gym pal for whom it worked.

Let me first say something: I am one of those who believe that the food pyramid is completely wrong and the base should not be made of starchy carbohydrates, followed by sugars, up to a tiny pyramidion on the top to represent fats. Carbohydrates are indeed important, but so are fats and proteins, as I explained in my article on balance.

Back to the article that convinced me to return to animate this blog, I agree with most of the points, but there are some important details worth adding.

First, the things I agree with


Massively increase the fat you burn
[...] our energy stores are deeper if you’re running on fat

Both are obviously true, being fat-adapted is wonderful: I am fat-adapted myself although I avoid ketosis (it gives bad breath and the sweat smells like nail polisher).
The good news is that you can still be a fat burner while staying on a “moderate carb diet”. Let me paraphrase this: you can get the best from both worlds and this is even more wonderful than being in ketosis: humans are equipped with an hybrid engin and as such this is how we should use it.

You hold less water weight on a low-carb diet.

True with a caveat: you must eat healthy fats, which is what saturated fats are anyway. Rancid and oxidised poly-unsaturated fats will cause inflammation and consequently water retention. This is the reason why the paleo diet doesn’t work for those doing it wrong (paleo bread, paleo muffins, paleo pizza crust…). Eat real food!

Get your carbs from non-starchy, nutrient-dense veggies
like broccoli, bok choy, fennel, and kale.

The second part is common sense and as my clients know, this is what I preach.
The first part, avoid starches, is half-true: they should be avoided when you are inactive, but are almost a must after (and not before) an intense workout. Glycogen stores in the muscles and possibly also the stores in the liver are depleted, that’s the ideal moment for a reasonable carb-refill: insulin sensitivity is at its top, you’ll spare aminoacids and the little insulin produced will promote muscle repair and growth.

But now the interesting part.

The dark side of being low-carb…

… especially when protracted for long periods and even more if you are into a high-intensity physical discipline.

1. Adrenals health

Low blood sugar triggers a response from the alpha-cells of the pancreas to release glucagon, this very important hormone helps in maintaining glycemy within acceptable ranges. Constantly low blood sugar levels caused by a low-carb diet sometimes are too much and, just like the beta-cells of the pancreas that release insulin to remove sugars from the blood, the alpha-cells can slow down. Enter the adrenals.

The adrenals are emergency glands, despite being small they play several fundamental roles to keep us alive. Critically low blood-sugar levels are indeed an emergency (you may go comatose…), and the adrenals respond by producing cortisol and adrenaline.

The first is an anti-inflammatory hormone, so far so good. It also activates the liver to convert fats and amino-acids (and therefore proteins) to produce glycogen through a process called gluconeogenesis. In other words, it impairs muscle growth and potentially triggers muscle break-down. I am not sure how studies can show that being in ketosis promotes muscle growth in the long period. My take is that other factors play a role in this, like the fact that fasting activates the release of HGH but again: you are cheating your endocrine system to bulk-up, are you sure you want to do this on a regular basis?

Adrenaline, too, activates fats conversion in the liver (good news: it doesn’t break down amino-acids), it also impacts the brain by raising alertness, this is the reason why, once you are truly fat-adapted, fasting gives you mental clarity. It is an highly addictive sensation so I am not surprised that many low-carbers feel so enthusiastic about their peculiar diet. And if this were not enough… caffeine by-passes all processes and directly stimulates the adrenal glands to produce more adrenaline. And the disaster is just around the corner, the two poor emergency glands that Nature intended to be reserve soldiers, are now fully employed on the front line in a fight for survival. The biggest problem of long periods of low-carb (and excess of caffeine, the two usually go together) is that adrenals too may fail: they are emergency organs and should be used occasionally, if you keep over-stimulating them why shouldn’t they fail?

Adrenals also produce sex hormones, in particular testosterone. If you keep them busy producing cortisol and adrenaline (emergency hormones) they won’t bother producing libido-enhancers, that’s definitely not the right moment. This is dedicated to you guys: having a belly that looks like Batman’s carapace is useless if… (I let you finish the sentence). My case is well supported by a consistent number of guys complaining about this on several forum. By the way, it is perfectly possible to show a 6-pack even on high-carb diets, as several vegan athletes seem to confirm.

2. Thyroid health

I will never repeat it enough: the food you eat is not just calories and anti-oxidants. When you eat you are sending messages to your body which will respond accordingly.
Low-carb diets are a clear message that famine is coming: less variety is never a positive sign. So it is time to down-tune the metabolism in order to burn less. One of the many ways to burn less is to limit the thyroid output which, as some of you may already know, is a situation where you don't burn body fat anymore, no matter how little you eat.
In addition to a reduced output from the thyroid, the liver also needs glucose to convert T4 into T3. Low carb diets will definitely make you lose weight quickly in the first weeks/months. You’ll get it back later with the interests.

3. Insulin resistance

Yes, as strange as it seems, your muscle cells can become insulin resistant not only by eating too much sugar (for periods too long), but also eating too little of it (for periods too long). This mechanism is designed to save glucose for the brain and from a survival point of view this makes sense big time: it is more important to avoid going into coma rather then outrunning Usain Bolt in the 200m.

Final words

For decades we have been told that fats are bad. Fortunately, recent studies and the honest reanalysis of old studies that have been deliberately hidden because they didn’t conform with Common Wisdom, are putting this fad to an end. Although people still find counterintuitive that eating fats won’t make you fat, there is a growing awareness of this and that can only be a good thing.

On the others side, it seems humans can’t live without a villain to hate, it must be evolutionarily hardwired in our brains. This time it is the turn of carbohydrates: will it last just some years or, like it happened with fats and cholesterol, shall we re-discover ourselves sicker than ever in 4 decades from now?

I am back writing: stay tuned, do you exercises dutifully and have some baked potatoes with your roasted duck!