When Confirmation Bias is the Landscape, Dialectics is Your Path to Better Truth

I woke up yesterday to a bit of a surprise. Mike Eades, MD, has a new post up concerning a Twitter debate he had with one of my frequent commenters and a collaborator for a few posts I've published here, with a view to better understanding of things like the gut biome (glycans, "animal fibers"), carbohydrate intake (fresh kill, raw meat and sea mammal glycogen), glucose tolerance, and chronic ketosis amongst a good testing ground: the Inuit. The Twitter debate was spurred by one of those posts. Here they are:

Since they live at the margins, the cool thing about studying the Inuit is very simply—from a scientific-methodological perspective—that there are fewer confounding variables to consider.

However, in Dr. Eades' view, pointing out inconsistencies in the standard narrative surrounding the Inuit constitutes "confirmation bias" and "cognitive dissonance," while holding to the standard narrative and dismissing many reasonable questions, facts and interpretations is a demonstration of impartiality and cognitive consonance.

You may have noticed in the way I write that I don't go out of my way in pointing out bias. And while I appreciate pointing out logical fallacies in argument, I'm not much of a policeman about it. The Dialectic is the reason, specifically Fichtean or, Hegelian Dialectics. Rooted in the Socratic method of inquiry—and distinguished from debate and rhetoric—it's how I have predominately viewed and engaged in human discourse for over two decades.

THESIS ---> ANTITHESIS ---> SYNTHESIS

The Synthesis then becomes the new Thesis, and the process repeats ad infinitum; not in circular fashion, but rather, a spiral fashion where each cycle represents more knowledge, better understanding, get's a little closer to the truth. As such, I never have to worry much about someone's bias. Let them be as biased as they like and then synthesize new understanding from competing bias. Someone's comment on a post of mine might be 90% logical fallacy—or just mostly bullshit—but 5%, or 1% decent antithesis from which which a synthesis might emerge and in turn, a new, more complete thesis.

...Or, you can waste endless hours debating who's right and who's wrong; who's biased and who's impartial; who's cognitively dissonant and who's consonant. Or, you could be making progress recognizing that in all likelihood, you're both right, both wrong; both biased; both living in some measure of dissonance and contradiction—in different proportions, contexts and perspectives—and there's a synthesis dying to get out if you could both simply embrace intellectual honesty.

Getting the hang of it?

Let's consider for a moment that this blog—with its 4,000 posts and 80,000 comments over 10 years—is basically just one huge-ass Dialectic where, most posts are in some way either theses—to advance or support some bias I hold—while the others are antitheses—to advance my bias counter the bias of others. And where, very importantly, the comment threads drive the whole thing. Moreover, most of those posts—because it's a blog, there's competition for mindspace, and there's an entertainment element—are encapsulated within my own style of rhetoric. But the rhetoric is not ultimately important, merely my attempt to get you to read—which is why I was just as passionate in my anti-starch posts several years ago, as I am in my pro-starch posts today. If you don't try just as hard to get people to read and consider your thesis or antithesis, then what's the point?

There's a few simple antitheses I'd like to offer concerning Dr. Mike's post.

  1. Someone can be 100% biased, but still be the most right upon critical evaluation of relevant facts; while the so-called impartial saint can be more wrong. In other words, charges of bias or cherry picking are actually non-sequitur, or red herrings. Such accusations can also actually be a diversion tactic, when one is uncomfortable about new information, or a better understanding or integration of it. Or, rather than engage in cognitive dissonance, accuse your opponent of confirmation bias.
  2. Demonstrating that someone is biased is not the same as supporting an alternative hypothesis. For example, hearing for the 10-thousandth time that Ancel Keys confirmed his bias in cherry picking his Six Country Analysis (not the same as the Seven Countries Study) does absolutely nothing to support the alternate hypothesis (antithesis) that saturated fat in abundance is good for you and is heart protective and healthful.
  3. Ironically, if you look at the comment thread as I last saw it at about 50 comments, it's largely a lot of people saluting their authority for helping them to confirm their bias, in a post about confirmation bias!

As to point three, I happened to see this tweet by Nora Gedgaudas linking to Dr. Mike's post:

Finally! A voice of reason in the 'resistant starch' debate: bit.ly/QngFx3 Thank you @DrEades

There's only one problem. Mike didn't mention resistant starch one single time in the post, nor was the post about that in even a peripheral way. I got from several sources that at the recent Paleof(x)—where Nora, amongst many others, spoke—VLC is basically considered over as part of the Paleo paradigm—at least in terms of top dogma. Too many antitheses—many involving the practice of starch eating, and they are backed my many n=1 (and just try to tell someone that your thesis or antithesis trumps their n=1). So, perhaps the embrace of Perfect Health Diet levels of safe starches, combined with the whole irresistibility of  resistant starch, has many who're holding to a VLC thesis of Paleo somewhat uncomfortable.

To summarize, don't waste your time pointing fingers at cognitive dissonance or bias; and besides, neither Duck or I have a bias against low carb (he lost 40 lb, I lost 60 on LC). Rather, we simply want all relevant information integrated into the general narrative, not just brushed aside in some pretense that this is all settled. Instead, embrace the primary thesis that we're all human, reject the antithesis that implies there exist pristine impartial superhumans that rise above such tawdry faults, but be intellectually honest and listen to every antithesis you can get your mind around. This is why I read every single comment posted to my blog and follow virtually every link included. I can't even count the number of times I've been sent down a rabbit hole that eventually caused me to form my own antithesis, from which I could have a synthesis, and a new thesis (Marketers: this is the essence of A/B testing). Not the absolute truth, just a step closer.

And if you're smart, you understand that the journey (dialectic) is infinitely more important than the destination (absolute truth).

Alright, so lets get into some specifics about our Antithesis or, why these questions, objections and interpretations are reasonable and need to be integrated into the Inuit narrative in order to achieve a better understanding of how they do (or don't) inform sound dietary and health practices in the modern world.

THESIS

Owing to the environment, the Inuit ate very little plant matter, thriving instead on the flesh of land and marine animals. Their diet was high fat, moderate protein, and very low carbohydrate. As such, they spent much of their time in dietary ketosis. They exhibited pristine health and therefore 1) high dietary fat, and particularly saturated fat, is good for us 2) very low carbohydrate intake, leading to a state of perpetual ketosis is good for us, and 3) dietary fiber is likely not very important to modern health.

ANTITHESIS

1. While it's true that  the Inuit did not thrive on plants, there's reasonable evidence to suggest that they knew much about plants, made use of lots of them, sought them out, and prized them. Here's a comment by botanist Arthur Haines on a PrimalDocs post.

That said, the Inuit were not strict carnivores, they were omnivores who consumed the lion share of their calories as animal foods. However, they consumed a relatively diverse selection of greens, fruits, and roots when they were available during the growing season. They also stored many of these same foods in oil-filled seal pokes for preservation. Greens included species of dock, willow-herb, rose root, sea-sandwort, and saxifrage. Fruits included baked-apple berry (a raspberry relative), crowberry, and cranberry. Roots included alpine sweet-vetch. It is estimated that 50% of some arctic indigenous population's vitamin C intake were provided by these plant foods. Further, they ingested medicinal phytochemicals through these greens and fruits that would have fought inflammation, sickness, cancer, etc. Just as there is no indigenous group who was entirely vegetarian, there was no group that was entirely carnivorous.

Melissa McEwen, in a post from 2012 about the book, Plants That We Eat: Nauriat Niginaqtaut - From the traditional wisdom of the Inupiat Elders of Northwest Alaska, wrote:

Perhaps Anore Jones is part of a conspiracy, but if she is, it seems to be fairly usophisticated, because almost none of her book's content has been disseminated online and it contains recipes that use such crowd-pleasing ingredients like seal oil and fish heads. Her book is called Plants That We Eat and it's 240 pages, which is curious for a culture that supposedly eats no plants. If it's fiction, she's done a rather miserable job and I suggest you read Borges' The Book of Imaginary Beings instead.

But I doubt it's fiction. She lived in Kotzebue with Inupiat for 19 years and has numerous photos of them preparing plants. I think people with plant-free anecdotes may have either not spent enough time with the Eskimos or might have not had enough contact with women.

She also quotes Jones from the book:

My grandmother would always dig the roots of roseroot when she could. She buried them in sand and grass on top of a high knoll. If hard times came when we were short of food, we'd know they were waiting. As long as we had seal oil, we could eat them. - Bessie Cross, an Inuit who Anore interviewed [...]

In a good berry year the otherwise green tundra actually has a blueish cast from so many berries. Even after people and all the creatures have taken their fill, the berries will still be thick. They freeze on the bushes and on the ground for the mice and ptarmigan to eat all winter and are there, dried and sweet, for bears, birds, and people to eat next spring. It’s such an enormous wealth of food, but one never to be counted on, for in a poor berry year you will walk all day and not find enough to taste. Then the animals that ate berries must find other foods and some must eat each other. [...]

The root of the yellow flowered oxytrope (Oxytropis maydelliana) has been eaten from Sealing Point in the historical past. It is also known as aiqaq and eaten in Anaktuvuk Pass and Canada. It occurs nearly all over Alaska and Northern Canda but is eaten only in certain places.

A.E. Porsild, former Chief Botanist of the National Museum of Canada, in a paper entitled Edible Plants of the Arctic, written for the Encyclopedia Arctica, a project guided by Vilhjalmur Stefansson, wrote:

Among the Eskimo--the most widely distributed race of arctic aborigines the dependence on vegetable food varies from group to group according to tradition and according to what plants are available in the area occupied by them; thus, to the most northerly tribes the use of vegetable food is purely incidental and largely limited to the partly fermented and pre-digested content of the rumen of caribou and muskoxen, whereas in the diet of the Eskimo of southwestern Greenland, Labrador, and western and southwestern Alaska, vegetable food constitutes a regular, if not very large, item.

2. In addition to the plants they ate when they could, they got significant fiber from animals (see the first 2 links in the list at the top of the post; also, here). This is part of why it's difficult to compare their meat-eating diet to ours because they typically ate nose to tail, and they ate it fresh. Fresh, the animal—even the blood—is chock full of "animal fibers," just like raw mammalian milk, that feed gut bugs.

3. Another source of carbohydrate for the Inuit was the glycogen in fresh meat, eaten raw (see the 3rd & 4th links at the top of the post). While this seems to have been Dr. Mike's chief consternation in the debate, I find it mysterious because there's no comparison to fresh and raw vs. hung and aged (glycogen depletion is the reason meat producers age meat—it's analogous to ripening fruit—and they use things like electrodes to speed the process). Moreover, owing to the demands of diving for long periods to great depths, sea mammals have significant glycogen stores. Whale blubber has been measured to be as high as 30% carbohydrate! Perhaps that's why they call it blubber, and not simply, fat.

4. If the Inuit really are in perpetual ketosis, as Dr. Mike seems determined to uphold as a critical part of the thesis-narrative, then what state were they in when fasted for a few days, and their glucose tolerance went to hell in a hand basket (see the 3rd link at the top of the post)? While thriving normally, they could handle a bolus dose of glucose and not spike over 140, demonstrating absolutely normal tolerance to glucose that's gold standard in the modern world.  After a few days of fasting, the same bolus dose gave them glucose readings to 300 and at the 3-hour point, they were still above 230. In the modern world, this earns you a clinical diagnosis of diabetes. So what gives?

Moreover, how does that mesh with the thousands of comments on the blog I've had from LCers over the years, and that meshes with my own experience and the experience of my wife and close family; where, after a long time LC, you have morning fasting numbers of 110ish—when 80-90 is normal—and if you do happen to take a bolus dose of carbs—like a piece of birthday cake—you spike to 200 or more?

More, moreover, how does that mesh with the experience of myself, wife, close family and so many commenters that by simply nudging up the carbs to Perfect Health Diet levels, everything resolves within days?

5. Dr. Mike also seems to insist that the Inuit were moderate protein, when the studies I posted  (see link 3 at the top) demonstrate otherwise. The average is 250 grams of protein. Try it daily. I have, as part of a Leangains protocal over about 6 months. It is very difficult unless you just drink it. But, if you're cold because you live where it's about the coldest place on earth inhabited by humans, and you have to work real hard to survive, then it makes sense. 250 grams of protein daily is not even close to "moderate protein." Just try it.

Moreover, given the brain and other-organ requirement for glucose, is high protein the real, underlying "golden helmet" for perpetual VLC? More moreover, given what Jimmy Moore has demonstrated with his "nutritional ketosis"—that demanded that he cut the protein to low-moderate levels to get and stay in ketosis—mean that's why researchers in 3 studies spanning over 40 years did not find ketosis in Inuit?

I might could go on, but let's just take the 5 points above and see what kind of Synthesis we might derive, in comments. Gotta let you readers have some fun.


Let's wrap this up. Let me be clear about Dr. Mike Eades first off. I am simply unsatisfied in his answers and the way he's characterized it in his post. I'm not "disappointed," which is the condescending characterization so many indulge in, but I won't use. I think it's still safe to say we're friends. I hope so. Mike has helped millions of people, I acknowledge and recognize it.

But nothing is settled, ever. I prefer it that way.

Be open to all the antitheses, especially from people who accept much of your thesis-narrative. For example, just recently, the whole question of starch intake and what caused brain size explosion has come into question. Check into Nutcracker Man, and how it's a misnomer; because, what he was eating was an endless supply of soft sedge tubers under weeds we commonly refer to as tiger nuts. Check into how the nutritional profile is off the charts.

Check into how C4 plants give us a better, more consistent understanding of a great deal. Early man as mostly carnivorous never made complete sense to me. I was around a lot of animal hunters, bird hunters, and fishermen when I was a kid.

I'll leave you with a very gentle video by a very gentle man, Arthur Haines. The Myths of Paleo or, in my parlance, the various antitheses.

Everything Update. But Mostly Gut Microbiome and Resistant Starch

I really need to spend way more time getting the book ready for the publisher, in my eyes (now editing chapter 6 of 15, and accelerating); which means, excruciating editing at word, sentence, paragraph, section, "science sidebar," and chapter levels. Convey the ideas in the fewest words possible. That's the creed I go by. I truly do believe its going to be amazing; and if not, I fail. Tim and Grace both knock my socks off. Makes it easy foundationally; but so hard, too, because I want those ideas and wealths of information to shine in a very particular narrative, and it's nothing like writing this blog here.

A word of thanks and deep appreciation for your continued support. The Amazon deal (see all the links and banners all over) is going so very well. Every day, many of you are hitting the link, or just clicking on a banner, and doing your shopping. Here's how it works:

  • Anything you purchase over the 24 hours after clicking the link or a banner, I get some help from Amazon.
  • Anything you put in your cart, I get the same help from Amazon, so long as you check out within 90 days.

Simple and elegant. A company most people love and trust, and you don't even have to buy what I'm peddling. You can buy anything you want (I see TVs, cameras, stereos, kitchen appliances, etc., in the reports). One time, a gal must have been outfitting a sports bar, so I got a piece of an order for 12 flat screen TVs. 2,500 units of various things ordered in March, 3,600 over the last 6 weeks.

That said, the only things I will ever peddle myself are things I use myself and find value in. The hottest thing now is the soil-based probiotics. Since I first did the post on them in late February, about 1,500 units out the door in total, for the three of them. One Tweeter tweeted me just this morning:

@rnikoley Thought dreams were good on RS alone. Popped my first Prescript-Assist yesterday and holy shit. One after another w/ movie

Turns out to have been something about Keith Richards in Todd's living room, discussing blues musicians. What will your dreams hold?

Thank you very much. You motivate me to do better. Oh, BTW: Go get your soil-based probiotics if you like.

...OK, here's my cool stuff for you, before I turn to preparations for recording Jimmy Moore's The Livin' La Vida Low Carb Show late this afternoon as guest host. If everything goes according to Skype testing, I'll be recording the show from San Jose, CA, on the line with Dr. Grace in Shanghai, Tatertot Tim in North Pole, AK; and to close things out, Tom Naughton from his farm in Tennessee. It'll be about the gut microbiome and resistant starch, but with an emphasis on how low carbers can benefit without sin. :)

~ Speaking of Tom Naughton, did you know that Tim, Grace and I collaborated on an extensive interview with Tom about resistant starch? In total, it comes out to almost 11,500 words, and here's Part 1 that Tom has published, with a really great mix of intelligent comments so far. Oh, I see that just this morning, Part 2 is up, and I haven't even read it myself, yet. I hope you enjoy what we tried to do in answering questions in different styles—something for everyone. You can guess which style I took up.

~ Speaking of Tatertot Tim—more popular on my own blog than I—he did a podcast with Ameer Rosic. My own podcast with Ameer a while back is at nearly 5,000 listens and Ameer asked me for a Part 2. I suggested that he go with Tim (and I'm going to suggest that he delve deep into science, medicine, pharmacology and clinical practical experience with Dr. Grace, as his part 3).

~ If you have paid any attention to me in the past, you may know that I have a serious crush on Terry Gross, whom I consider to be the very best all-around interviewer of our time. Most recently, she has interviewed Dr. Martin Blaser.

There are lots of theories about why food allergies, asthma, celiac disease and intestinal disorders like Crohn's disease have been on the rise. Dr. Martin Blaser speculates that it may be connected to the overuse of antibiotics, which has resulted in killing off strains of bacteria that typically live in the gut.

Blaser is an expert on the human microbiome, which is the collection of bacteria, viruses, fungi and other microbes that live in and on the body. In fact, up to 90 percent of all the cells in the human body aren't human at all — they're micro-organisms.

Blaser is the director of NYU's Human Microbiome Program and a former chairman of medicine there. His new book is called .

What's covered:

  • On why he thinks the number of diseases has risen
  • On the potential link between antibiotics and obesity
  • On how the birth process informs a baby's microbiome
  • On a study comparing the microbiomes of babies born via C-section and those born vaginally
  • On how the microbiome can determine a person's immunity and allergies
  • On probiotics

Not to toot Grace's, Tim's, and my horn, but virtually all of it has been in our book for months, under editing, revision, and inclusion of the latest science. No surprises. But, you will for sure want to read our unique perspectives when it comes out. Our perspective of the whole thing is quite a bit different, fundamentally.

~ On the allergy issue, there's this: Pollen is Not the Problem.

When the gut is out of balance, opportunistic and pathogenic microbes overgrow and take over dominance. These pathogens produce toxic substances which are the by-products of their metabolism. Some of these toxins actually play an important role in the body when the pathogens in the gut are controlled and kept in check by good flora. But, when the good flora is absent or not playing a dominant role, these pathogens can overproduce these toxins.

One such toxin produced by several types of gut pathogens (Proteus, E. coli, Staphylococci and others) is histamine which is actually an important neurotransmitter in the body.

When these microbes grow unchecked in the gut due to a lack of beneficial flora, they overproduce histamine causing many functions in the body that react to histamine to go haywire as excessive amounts pour into the blood.

Is Benadryl your best friend? If so, you know you potentially suffer from an overgrowth of pathogens in your gut that are overproducing histamine!

I don't care for exclamation marks in that context, but for me it has been over the top amazing: sneezing, wheezing and dripping since I was 13. It happened within 3 days of eating the dirt. I breath clearly through my nose, for the first time in life memory. Thanks, Grace.

~ There's a study out about the first looking into of the Hadza gut microbiome (full text). There's a couple of articles written about it, here and here. A graphic from the latter link in Wired.

Hadza gut microbiome figure
Hadza gut microbiome comparison

I'm not going to go into details but as it turns out, the results are surprising because they appear to have more of what we'd tend to think of as pathogens, less of what we'd tend to think of as friendly—in an American SAD context. It's compromised, though, because they stored the poop in a harsh solvent to preserve for testing; whereas, Jeff Leach—in his ongoing project—has the foresight to freeze them, so as to preserve a poop in time.

But let's just take the existing data for what it is, for now. I'm an Occam's Razor kinda guy, and given that that Hadza exibit none of our Western maladies, their guts just rock and yours are pathetic. Fair?

What I think is that ultimately, while these sorts of studies are surely going to provide very valuable insight, they're ultimately only going to serve as practice and foundation for the testing to come:

  • Rather than test Hadza living in the dirt, against 5th Avenue apartment dwellers in New York, you test healthy Hadza against unhealthy Hadza (if you can find any), and heathy Manhattans against unhealthy Manhattans. This is the environmental angle.
  • To go even a step further, you test healthy Manhattan Jews against unhealthy Manhattan Jews. This is the social angle that incorporates the environmental.
  • This is how it drills down.

There is no "healthiest gut biome" in the world. There is potentially healthiest in an environment, and beyond that, healthiest in a socio-environment. Then, we'll be getting somewhere and the discoveries are going to be so fucking gobsmacking I can't even believe it.

...And, just as Dr. Grace has admonished us so many times, once they adjust all the above data to various levels of antibiotic use, the picture is going to be just as she said. The unhealthy in the same socio-enviro will have had high antibiotic use and they healthy, relatively less.

Honestly: Do You Really FEEL GOOD About Having Filed Your Papers Today?

If you feel really good, then good for you; I'll leave you alone. I'm sure your wager to have others pay for you beyond your ability to pay for yourself will pay off. Your conscience—beyond the dusty items of defeat or resignation—will be clean.

You're fine. Don't worry, be happy. Human Animals are going to take up the slack anyway. So relax.

baby birds feeding
 

Make sure you have your papers stamped by the Postal Bureau on time.

...You might turn into a pumpkin and/or be the subject of a psychotic heir in a realm where everyone thinks that's normal and you're strange because only one shoe fits.

Just go file your papers and don't worry about glass slippers. Pop a cork for The Land of the Free.

Don't worry. Be happy.

Free Will and Tabula Rasa is Dead; But So Is Materialism. Connecting Dots.

The Enlightenment idea of Free Will, or Tabula Rasa, is one in which humans are deemed to have been born clean slate, no intrinsic behavioral programming. It's often juxtaposed with the observed unlearned behavior of animals, called instinct.

On the other end are the materialists, who essentially hold that we're merely a product of genetics that call forth certain cellular chemical processes that effect brain processes, and everyone is just a product of an evolved genetic code—blameless—and it's for us to select enlightened leaders to socially engineer things so as to minimize carnage.

I regard Free Will as a means by which humans can be made to feel unearned guilt. I regard Materialism as a means by which humans can rationalize any behavior, along with regarding guilt as social construction. Metaphorically, it's a philosophical battle between Angels and African Cats. ...Angels have free will, if you've ever heard of Lucifer.

Moreover, I regard the former as a crutch for religion—the idea of sin or Original Sin—and the latter as a crutch for socialism, as everyone is an innocent, blameless victim of their programming.

For many, many years, I've not been an allie of either—though I now believe I was still mistaken, had not connected all the dots. It's the classic sort of dispute...in which, one must pick a side. But I hate picking sides—because all sides are obsessed with a side and thus, always wrong. So, for a long time, I've called myself a materialist, except for free will (I wasn't trying to be funny).

And now, that changes.

Animal Behavior and the Microbiome

But humans are not the only animals with microbiomes, and microbiomes do not just impact health. Recent research is revealing surprising roles for microbiomes in shaping behaviors across many animal taxa—shedding light on how behaviors from diet to social interactions affect the composition of host-associated microbial communities and how microbes in turn influence host behavior in dramatic ways.

...Just wait until you read the bit on the lifecycle of the liver fluke in our upcoming book; which reminds me...I've got to get back to work, or Tim is going to have my ass.

So, here's where I'm at now. Humans have neither free will where they're necessarily culpable in all action, nor are they materialist-blameless and guilt free for any deed. It's a complex combination where humans are 10% of the total cells of a human body, 500-1,000th the combined species of a human body, and 100-150th of the genome.

There is perhaps an alien mind control aspect to it but perhaps the reconciliation I seek is to be found in a simple distinction: It's not free will, but it is the power to exercise conscious will and it's something that almost everyone has experienced, regardless of the makeup of their mocrobiota. That only means it's easier for some, but not entirely out of the reach of anyone I've ever experienced. Easy for some, fucking difficult for others.

So, to my mind, we have the potential of a new philosophy where you're neither all guilty, nor all blameless. But, you still have some power.

It's complicated.

I think this notion has the potential to revolutionize philosophy, and everything human ultimately flows from human philosophy over the questions of why. It's why so many of you health/diet bloggers don't have the readership you may deserve on the 1+2 merits of your work. You have to connect it all to deep contemplation.

Consider that the idea I've just put forth has the potential to unite free will, materialism, and even the observed instinct in animals. Is instinct in lower animals simply a far lower resolution of human-like intelligence, where there's no extant power of will that by definition in this context, is the power to override the chemical-signal influence of the microbiota, because they don't deal in intellectual conceptualization and metaphor?

Is the human power of will a double-edged sword, essentially—literally—what makes us human when called for, but a noisy signal when we ought to relax and go with the flow?

I can't begin to sort out all the possibilities, so I'll leave it to comment contributors at this point.

“Paleo” Is An Exclusive and Not Inclusive Diet: What Are You Eliminating Rather Than Including, Next?

One way to chew on that title is to realize why Low Carbers have had success infiltrating Paleo Ranks. They merely restrict a macronutrient (carbohydrate); so, if they have no allegiance to Paleo, They can eat as much cheap soy-oil mayonnaise as they like, while scoffing at your super expensive grassfed butter.

It's an extreme example, but serves to illustrate the difference between just excluding a macronutrient (carbohydrate) and going Big, excluding lots of bad stuff (anything bad, all macronutrients). In other words, it's arguable that Paleo is more restrictive than Low Carb—even with plenty of carbs—in a quotidien context.

Food for thought.

In everything I saw this afternoon—after 30 hours of zero Internet—this interested me the most:

Depressed (Updated)

Depressed today. Ate starches several days this week. I’ve been feeling dull the last few days, and today it’s full-on depressed. I’m sure it’s because of the starches…because this is what happens. But you know what? I’d really like to be able to eat a slice of home-cooked gluten free bread now and then without it having such a dramatic effect on my mood. I’m tired of having to stick to such a restrictive diet in order to feel ok.

After reading this post over at Free The Animal, I’m asking myself if my current restrictive diet (basically just dairy, coconut oil, butter, meat, eggs, fruit, juice, seafood (1x a week), liver (1x a week), and sometimes chocolate) is really just symptom management. I feel great when I’m able to stick to it for a string of consecutive days, but eating the same 9-or-so things is monotonous and isolating. I don’t feel like I can eat at restaurants or sit down to meals with my family, because most often I’m having something weird like juice and cheese for dinner.

I think you all need to be policing yourselves a little better. You're creating a culture of exclusion, of catechism, and of doctrine. At the same time, you can't police everyone, nor can you help everyone.

This is why Culture matters so much and I'm suggesting to you that the whole Paleo food culture of exclude, exclude, exclude is not right; or, you're not really going out of your way to emphasize the importance of reasonable amounts of sane carbohydrate via starches and fruit.

What's above is only posted as "what's going to happen more and more," and it's just that this one person looks a bit beyond help, to me. An update to the post.

It occurs to me that I should really put some effort into learning how to cook with the few ingredients that make me feel awesome so I can learn to tolerate a restrictive diet. I’ll share the recipes I come up with.

I'm suggesting that anti-grain, Paleo folks really take to heart the neuroses they may be encouraging. I've been guilty myself, so this is a wake-up-call for me.

Ever heard of the east meets west metaphor? Vegan meets Paleo. Head that shit off, please.

The Best General Explanation of Resistant Starch Yet; Eye-Popping 4-Minute Video

There's nothing like someone making something as simple as possible, but not too simple. It's perfect, and right after I post this, it will be added to the "Newbies' Primer" on Resistant Starch.

The Hungry Microbiome: why resistant starch is good for you

Really, share this one around big time. It's short & sweet, and carries a powerful message.

Share 55 Google +1 8 Pin it 5 0 Retweet 12 Like 143 Google +1 8 4

The American Food Project Rings in For a Commenter and Not Good (Why Resistant Starch Doesn’t Work for Some)

Tatertot Tim put this together for us, in collaboration with Dr. BG (Grace)

What's Lurking in your Guts? Potato Starch as Litmus Test for Gut Health

Earlier this week I was copied on an email from frequent FTA commenter Nancy, who had some important news. Her American Food Project results were in and she was a bit concerned:

Subj: Results from American Gut: my innards are quite f*cked up

Results attached with crude photography below.

For context, I was the one who responded the worst to the PS. Started it twice, about six months apart, and it led to nighttime and morning loose and urgent stools. It just wasn't working. Now we know why.

My population was/is PRET-Ty sucky. And Googling some of these geni and families is freaking me right out. The same family as the bacteria causing the plague? A bacteria extremely populous in me that is only supposed to be in whiteflies?? I'm a bit nauseous! This is like the opposite of Tatertot Tim's profile!

I took one glance at her AmGut report and could tell she was right, her innards were quite f*cked up.

photo 1
 
photo 2
 

Apparently when Nancy got these results, she started looking up names and discovered that some of these microbes were disease-causing and belonged in a whitefly. I did the same thing when I got my results, if you’ll remember: Resistant Starch: American Gut Project Real Results And Comparison (Very Big News).

The report also noted I had some rare types of microbes...

  • Victivallaceae - A producer of acetate
  • Limnobacter - A bacteria normally only found in high mountain glaciers, a tribute to my Arctic life, I suppose.
  • And my favorite—because I am often thought to be a slacker—Slackia—a producer of a substance known as Equol.

[Editor's note: If Tim is a slacker, then I'm a reprobate derelict!]

With all these names readily searchable by anyone with one finger and an internet connection, it’s easy to get lost. Dave Asprey loved to tease that all my RS ingestion seemed to do for me was to insert rare gut bugs in my gut, completely ignoring the fact that I had virtually NO detectable pathogens: Is there such a thing as Bulletproof Resistant Starch?

In fact, “tatertot” who worked with Richard on this research, got his American Gut results back after lots of resistant starch. His biome was stellar, but it contained a lot of Limnobacter, a rare microbe normally found in glaciers. Who knows what’s going to eat the resistant starch you put in your mouth?

When I looked at Nancy’s report, a quick glance at the bar chart—with the massive area in keto-pee yellow—screamed at me. This is the bar we really don’t care to see. It's the bar that represents the Proteobacteria...the home of E. coli, salmonella, H. pylori, and cholera. Most people have a small band of these. But as you can see from the bars to the right of Nancy’s, most people have 5-10% of their sample represented by Proteobacteria. My sample showed I had about 2%.

So what's in this massive Proteobacteria band of Nancy’s? The charts show that one of her most abundant microbes is of the genus Morganella, at 25% of her total microbiome. But we're still missing a few specific microbes that comprise nearly 40% of her gut. ...So, I asked her to send me her full taxa report. From the full report, we can see that not only does Nancy have 25% Morganella, but also nearly 10% of an unnamed member of the Gammaproteobacteria Class, Enterobacteriaceae Family—which is precisely where E. coli lives. We don’t know for sure it’s The E coli; but at a minimum, we're talking relatives. Elsewhere on the report—in ranges of .02 - 2%—were no less than 24 other genera of Proteobacteria. For comparison, I had 12 genera. These are not all pathogens, and most are considered normal parts of the human gut. And, some Proteobacteria are actually good.

So, what’s the big deal? At tiny fractions, these bacteria are fine—everybody has them. A gut that has “broken bad,” however, favors the pathogens and allows them unimpeded growth and they then control the real estate. This is exactly what has happened in Nancy’s gut.

The genus Morganella has exactly one species—Morganella Morganii. M. Morganii, as it is more commonly called—that's en effing bastard of a microbe. But, it’s not that uncommon either—my report shows that I have approximately .01% of it. But it doesn’t take much Googling to find out that this is not who might want dominating your gut.

Morganella morganii is a facultative, gram-negative and anaerobic rod found in the feces and intestines of humans, dogs, and other mammals. It's known to be a causative organism of opportunistic infections in the respiratory tract, the urinary tract, and in wound infections. It can cause devastating infections in neonatal and postoperative stages—particularly in diabetic patients. The risk of infection is especially high when a patient becomes neutropenic as a result of myelosuppressive chemotherapy. Massive hemolysis can be associated with bacterial infection and has been reported mainly in cases of Clostridial or Vibrio sepsis.

But, it’s not all bad:

Morganella morganii is a species of gram-negative bacteria that has a commensal relationship within the intestinal tracts of mammals and reptiles, as normal flora. Although M. morganii has a wide distribution, it's considered an uncommon cause of community-acquired infection and it is most often encountered in postoperative and other nosocomial infections such as urinary tract infections.

Or is it?

M. morganii is motile via the use of a flagella. In some cases, it reacts to changes in the pH of the gut, as well as to changes in the state of the immune system. Since it's an opportunistic pathogen, it takes advantage of any compromise of the immune system—why it's most often detected  in hospitals after a serious injury or surgery, perhaps from its ability to hydrolyze and modify antibiotics through the presence of adhesins, and other enzymes.

When the host’s immune system is suppressed, M. morganii will rapidly invade the host and also cause specific IgA responses and as well as cause an increase in the volume of Peyer’s patches. It's also able to ferment sugar and is glucose positive.

So, it seems that in my haste to pimp prebiotics on an unsuspecting public, I told Nancy to go ahead and eat potato starch, one of M. morganii’s favorite foods.

When I’d realized what I’d done, I wanted to see what lame advice I gave this poor lady who, as I write this, is trembling and curled the fetal position as she awaits a call from the doctor to schedule an appointment—just kidding.

Our conversation on the blog went something like this, beginning early November, 2013: 

Maybe someone can help me. I think I have a bad biome. I have been gluten free and focused on healthy animal proteins and fats including coco oil for three years. I am quite overweight because I am a chocolate junkie. I tried the RS about 4 months ago, starting with 1 tbsp in the AM and one at night, going up to 2 and 2. After a few weeks, my TMI became late at night, first thing in the morning diarrhea. So I attributed it to the RS and stopped. The D lasted for about 3 more weeks, then finally became more normal. Because it still lasted, I ended up concluding that the D was from some other reason.

This week, I decided to really clean up my diet, and get off the sugar, mostly quality milk chocolate but also sometimes too much fruit, or crème brûlée. I was urged to try the RS again because of it help keeping cravings down. For three days I did 1 tbsp morning and 1 before dinner. After day 2 the TMI was changing. And after day 3, the looseness was back, and the urgency. I stopped RS today because I just don’t have the time to sit home in the morning.

Does anyone know what is wrong with my biome? Obviously something is amiss. I haven’t had any antibiotics for maybe 5 years except what they give you during a c-section birth two years ago. I also get migraines from any probiotic pills, liquids, or vegetables (I love kimchi but it doesn’t love me). I drink 1 cup of commercial full fat plain kefir a day, and 1 bottle of commercial kombucha a night in hopes of fermentation.
I suffer about 8 migraines a month. Maybe there is a connection.

Here was her plea for help...would the FTA community come through? You decide:

Richard Nikoley says:

Nancy, darling. Your comment is palpable to me.

You are suffering, girl. And it’s far beyond any advice I can offer. My only suggestion would be to fix your diet first, by which I mean no sugar that’s not in real food, no grains. Real food only you go out and get yourself, prepare yourself with whatever natural fats are your preference. Maybe feel free to include some of the foods touted for RS, but you probably ought stop supplementing it until you’re healthy.

You might consider seeking out pro help in the Real Food realm.

Then a nice number of helpful folks showed up, as is pretty common, here:

  • Nancy, based on what I know (but I could be wrong), RS works really well for gut dysbiosis, i.e., dysbiosis in the large intestine. It may not be that effective for SIBO or IBS.
  • I always crave chocolate. I find if I eat liver the cravings go away!
  • ...for what it is worth, what I found what worked for me a while back was raw, natural, unprocessed honey

Then, thank doG, Ellen came along:

Ellen says:

Nancy,

WARNING serious tmi ahead.

When you say that the PS makes you go more often, is it actual watery D or a well formed stool that is just frequent with cramping?

I was having the latter (plus headache) from more than a tiny bit of either PS or foods high on RS and have been taking Prescript-Assist for several days and it seems to be changing things for the better.

But, either way, I don’t think it can do you any harm to try a top quality probiotic.
The bottom line however is that nothing is going to change if you don’t get off the sugar. I would suggest that the higher carb end of PHD style eating might help you avoid the sugar cravings.

I had to have a say, too:

Tatertot says:

Nancy – I concur with everybody else! You would probably be wise to look for a naturopathic doctor and get this all straightened out. Right now you are shooting in the dark, something is going on, you owe it to yourself to get it fixed.

Don’t bother with the American Gut Project unless you just want to give them money. They take 6+months to get back with you and only identify gut microbes to the family level–not species level. Here is a better place.

This is a full report and quicker for not much more money. I have a buddy who can help you interpret the results if you need explaining, just post back here and we’ll get it figured out.

In the mean-time, green bananas have been used forever as a treatment for diarrhea in 3rd World Countries. I’d highly recommend buying a bunch of the greenest bananas you can find and eating 1-3 daily. If they are too hard to peel, slice them in half lengthwise and peel sideways. They taste like crap when that green, but eat while drinking hot tea or coffee to wash them down.

Oh, and quit eating milk chocolate! Learn to eat 100% Baking Chocolate, or buy the 90-100% candy chocolate. There is no high-quality milk chocolate!

Then Richard Nikoley says:

Nancy:

Please go also post your comment at my long time friend Dr. BG’s blog, Animal Pharm.

She can probably help.

So, you all decide: were we helpful or hurtful in this situation? I think we all handled it pretty well. It turns out that, back in November, Nancy had just sent off a sample of her poo to the American Food Project and decided she’d wait to see the results—returning to her diet that she knew would keep her in the most comfortable range of gastric disturbance, a low-carb paleo approach.

Also, in related emails, I dug a bit into Nancy’s background. She’s led quite a hectic life and her gut bugs have taken the brunt of the punishment. Many rounds of antibiotics, a benign brain tumor (prolactinoma on pituitary) removed—and grown back, and the usual array of health issues surrounding most everyone. She’s hypothyroid, and has frequent migraines. She’s Mom to 4 active children.

Would any of this info have swayed our musings? Probably not. So, what lessons can we learn from Nancy...amazing Mom who was overweight and had some TMI troubles, looking to resistant starch and a bunch of internet morons to help her out, i.e., just cut the carbs?

I think the big lesson we need to take from all this is that if potato starch f*cks you up, you need to go to a doctor ASAP. Get a full gut health report. Eating in a way that alleviates symptoms is not the same as eating in a way that is helping you out...it may just be doing the exact opposite! How many thousands of people get operated on every day in this same condition? Do doctors and surgeons routinely check for this kind of thing? Doubtful. It’s entirely possible that Nancy’s life will now improve, now that eating cheap Bob's Red Mill Potato Starch, 24-Ounce (Pack of 4) identified a clear gut problem. For many months, we have heard loud and clear from those who conclude it's not about them that they can't handle it, when the clear evidence is that better than 90% of people can.

Here's someone who took the time and trouble to find out.

...Another lesson is that if you think you have gut troubles, don’t mess around with the American Gut Project. Get a real test, like the Metametrix GI Effects stool analysis and get a urine test while you're at it. These will need a doctor’s help and prescription, involving insurance paperwork and all that, but it may end up really improving your life. The American Gut Project is wonderful, but only for basic amusement. It only shows the level of diversity you have in your guts—which is totally fascinating—but potentially misleading. It won’t show yeasts, or put up a red flag if something is seriously amiss. Had Nancy not thought to share her results, she might have just gone on her merry way thinking that 25% Morganella was perfectly acceptable. Nancy may also find she has even more sinister inhabitants when examined fully.

...The gut is an amazing piece of machinery. Your gut microbes can exert a form of mind-control and do it all the time. This M. morganii, for instance, that has taken over Nancy’s prime neighborhoods, loves to eat sugar. What was Nancy admittedly addicted to? Sugar. M. morganii should also be able to eat RS as it is a form of carbohydrate, but it’s almost as if Mr. Morganii didn’t want her to have it—because it would also feed his enemies...and...diarrhea for weeks!

Nancy suffers migraines, why do I have a strange feeling that these are related to her gut? Are these migraines the remaining few good gut bugs screaming for help? Or M. morganii hoping she’ll seek solace and comfort in a piece of apple pie?

What advice would Nancy have gotten from any of the other gastrointestinal ‘gurus’ out there? Hopefully, they would have first advised her to get a full report. We are beginning to see, now, that the information you can get from genetically sequencing your poop can add up to gold.

Nancy further relates, within the last few day, and a few months later:

I started taking Prescript-Assist Probiotic 6 weeks ago. With one a day, taken at night before bed. Within 48 hours my poop and my life changed for the better. Instead of quite urgent but controllable poop that was not on the Bristol scale (I liked to call it ‘sludge’), I went to shaped poop that kept the shape even in the bowl. On the Bristol scale and one of the good ones, I think. And if someone is in the bathroom, I can wait my turn. This was a change I welcomed.

As to Resistant Starch and her diet lately:

I only eat RS in the form of cooled rice really, right now. I was planning to start Potato Starch soon, now that my stools are changed and maybe my biome too? I have to go very easy with most fermented foods, like kimchi or real sauerkraut. Love them, but more than a tablespoon and I get a migraine. I drink a cup of commercial plain full fat kefir maybe 3-4x a week. I drink half to one bottle of chia kombucha a night. That is as much alcohol as I can handle without migraine. It's the weak kind of kombucha that you can buy under 21.”

Hopefully, when Nancy gets her gut bugs re-checked very soon, she’ll find that the Prescript-Assist, fermented foods, and rice have turned the tide and her gut is well on the way to healthy.

Some advice from Dr. BG on what tests to ask for can be found on her blog.

Grace’s thoughts on RS failures are that there are four main reasons why people can have a hard time when they first start an RS rich diet:

  1. SIBO/SIFO—Small Intestine Bacterial or Fungal Overgrowths. RS utilizing bugs in the wrong place (right bugs, wrong place). The only way to tell is with testing.
  2. Antibiotics have removed the RS utilizing bugs—over 25% of individuals make zero butyrate with RS due to missing ‘core’ gut bugs.
  3. Parasites, yeasts and pathogenic strains in the small intestines and/or colon—either too much (or too little) butyrate, propionate, or acetate production depending on which strains, how much and where in the enormous ecosystem.
  4. VLC or ‘Atkins’ type diets—drops butyrate to 1/4 of control diet. Symbiont RS-utilizing strains are decimated analogously, particularly Roseburia which tracks with butyrate production.

So if you think you have a serious problem in your gut, please don’t mess around—get it checked out. Maybe it's not the potato starch. Maybe it's you. Spend some money and get a real test done. Waiting 6 months for an American Gut report is fine if you're generally healthy; but if you cannot eat real food, like potato starch or cold potatoes—you just may be ill, from the perspective of a normal human. Resistant starch is an age-old food, one we evolved millions of years eating. If you can’t eat it, you probably need some modern medicine to find out why. Hopefully, Nancy will get her appointment and a new stool test very soon and she and her doctors will come up with a solution to restore balance and heal her gut fully. Last word is, she's well underway with that.

What’s lurking in your guts?

~~~

Editor's comments: Let me close with a little hubristic spice. It's not a question, anymore, about all the millions of folks who've invested countless dollars and time in oder to fully understand every metabolic pathway, every axis, or every single genetic expression that they just love to go on and on about.

None of it—regardless of how detailed and precise—has even a sliver to do with a scintilla of all of the foregoing. What does that mean? Smart people, but smart people who are literally back at the drawing board. Every one of them. And I'm talking day one, and kindergarten—and I care not their names or credentials. Meaningless.

  1. When they are talking about metabolic function, hormonal signaling, et al, they are talking, at most, about 10% of you. Until they fully integrate the gut biome's role in all of this and minimally, begin to start classifying different levels of healthy guts vs. bad guts, they ought be regarded as going bla bla bla.
  2. When they are talking about gene expression it's even worse, and more embarrassing, since our own genome is less than 1% of the total genome including the up-to 1,000 lines of microbiota.

I'll tell you what's far more hubristic, though; and I'm just alerting you, because you're going to see it a lot—from those who invested so much to be "experts" on 10% and 1%. It's very simple and you watch. You are going to see tons of people who are behind, who thought they were the Bee's Knee's tell you it's all a bunch of BS, don't look. Watch for being told not to look.

That's exactly how things shift from who knows nothing, to who knows everything—and vice versa—in every paradigm shift; and if the science of the gut microbiota doesn't represent a back-to-the-drawing-board paradigm shift in health and medicine, then nothing does.

Stay tuned for the book. The foregoing represents a Tim drafted, but Richard and Grace collaboration—with me as your final say editor. Hope you liked it.