Commenter Marie, Taking One For Her Dad With Cancer, Part 2

Not labeled as such, but here’s Part 1: PhD Physical Chemist Commenter Marie is at it Again! Resistant Starch and Ketosis. Low Carb in Short Pants. There, we learn that while trying to keep her dad in ketosis for cancer therapy while upping his food choices to keep him in the game, she initially had difficulty.

Why? Well, resistant starch supplementation does improve fasting blood glucose. That’s in the literature, and she duplicated it. It also blunts blood glucose spikes. That’s in the literature—also: “lentil effect,” “bean or legume effect,” “second meal effect,” etc.—too, but she was kinda only able to kinda duplicate that if V/0/LC and in ketosis.

Why? Here’s probably why, in my view: too very low carb, too ketogenic too often, too long. Simply stated, it wreaks havoc on the other 90% of you—your gut biome—and has downwind repercussions, such that VLC and ketogenic become solidly an intervention therapy (like for her dad’s cancer) and not a “healthy lifestyle.” Mind you: I have zero problem with the former. My beef is with the latter.

I have her data from back then and will publish it when I’m more sure I have more of everyone’s attention (it’s looking better and better by my secret metrics). But the “teezer” element is that after more time supplementing resistant starch via Bob’s Red Mill Potato Starch—that’s gonna set you back a whopping $13.50 for 96 ounces (6 pounds)—she actually had better results with a pure sugar carb load while in ketosis. Blunted by her flourishing gut, producing saturated fats (…that’s “SFCF,” for when you don’t want to get all LC/Paleo giddy about it and imply contradictions in your own thinking and conclusions. Thank God for SFCFs, so you don’t have to write “saturated fat” or “saturated, short chain fatty acids” when it might be “inconvenient.”)

Here’s how I ended yesterday’s post, quoting the lovely Marie:

Well, I did the test in fasted ketosis. Had changed plans for the weekend to stay fasted until this afternoon and of course have been looking at yogurt and honey rather than potato as the ‘challenge,’ food since that’s what dad misses most.

Now I feel like being une tease Gauloise (bien sûr!) so come on, before I tell you what happened, you tell me, what are your guesses? :)

Hint: BG effect was all over in 60 minutes, though I kept on testing ketostix until something interesting happened.

Now, here’s what happened; and, mind you, this is after several previous failed tests using resistant starch to blunt BG and remain in ketosis in the face of a starch/carb load. Here we go with Greek yogurt & honey which I guess is like Food of the Only Good Gods we Ever Had—the Greek ones.

~~~

The rise was just 18 points. It went from 83 to 101 mg/dl. 44hrs fasted. Took 2 Tbsp Bob’s Potato Starch (PS) in water during the fast (0 GL).

Then the meal : 2 Tbsp PS in water + 1 1/2 Cups Yogurt + 3 Tsp Honey.

Took BG every 15′ after end of meal.

  • pre : 83
  • 15′ : 92
  • 30′ : 101 (peak)
  • 45′ : 91
  • 60′ : 80 (~baseline)

keept going, just in case :

  • 75′ : 81
  • 90′ : 81
  • 105′: 82
  • 120′: 80

Been keto-positive, purple, at “40” all day and right before meal. Eau de nail-salon was very evident.

  • 75′ : still slightly positive, peach-pink, “5”. Likely due to ‘older’ part of excretion, before acetoacetate shut-off.
  • 2 hrs : null, no color change.
  • 3 hrs : null, no color change.

Technically, out of ketosis. Since false negatives are biochemically possible even with continual urine testing, would need blood ketone measurement to confirm. However, makes sense. Could have stopped here. But I didn’t. [This is the point. –Ed]

  • 4.5 hrs : slightly positive, peach-pink “5” (since this can always be ‘vague’, keep going…)
  • 6 hrs : yup, definitely pink-purple “15”.
  • 7 hrs : pink-purple “15”.

I’m off to bed now. If I could stay up, we’d find when it goes deeper purple, 40, but who cares, effect was detected. ketosis was recovered quite quickly. If I wake up at night like I sometimes do, I’ll check again.

So after 2+ months of taking PS, when now taking PS WITH the yogurt + honey I get only a small BG response EVEN in fasted ketosis, despite that state’s famous physiological insulin resistance.

This is also a controlled study, meaning we do know that physiological insulin resistance works in me too without PS, from earlier results under the same conditions.

Apparently, give me PS long enough and that resistance is much, much muted, to the point that the BG response is one of the lowest ever for this meal in any metabolic state (ketosis or not).

Bonne nuit!

~~~

A tu aussi, Mariechérie. Bien merci.

Three words: This. Will. Continue. So much for: “it’ll knock you out of ketosis.” Make the most of technicalities, if you like. I’m giving it to you on a silver platter. So go ahead, make Big Waves.

…Final note. How many remember the name of my politics/social blog before I changed it to Free the Animal? From about 2005-2008, or so, its name was Honesty Log. From 2003 until then, it was Uncommon Sense.

Noticing any common thread?

Update: Just going in to delete all emails on this and there was one from Marie I hadn’t noticed before. She wanted to ensure that her final ketosis measurement was actually 7.5 hour, NOT 7 hours.

Memberships are $10 monthly, $20 quarterly, or $65 annually. The cost of two premium coffees per month. Every membership helps finance the travel to write, photo, and film from interesting places and share the experiences with you.

59 Comments

  1. Wolfstriked on September 25, 2013 at 14:11

    Marie,another area you can look into is body PH with regards to cancer and how baking soda may cure cancer.Some doctors say that cancer is just a fungus that grows when the bodies PH drops too low.ALL cancer patients have very acidic bodies.;)

    I take BS twice per day at 1/2 tsp but have noticed in past 1/4 tsp per day is enough to make my urine alkaline,if i stay away from sodas etc.What I notice is that during the day my skin takes on a reddish unhealthy look and when I take the BS it goes away an hour later.This reddish look is something I notice in heavy smokers and drinkers……aka very prone to cancers.here is a video of a man who cured himself of terminal bone cancer with an extreme BS regimen.Good luck….

  2. BigRob on September 25, 2013 at 11:45

    Whoop Whoop!

  3. Stark Brandstone on September 25, 2013 at 12:09

    I said it on Facebook but it deserves repeating here: considering the massive impact that gut flora has on inflammation, immune system, central nervous system, autonomic nervous system and body composition thus resistant starch thread seems tome to be the most important dietary information anywhere.

  4. tatertot on September 25, 2013 at 12:15

    @wooo – I think you are missing the point. Most people doing ketogenic/VLC/LC diets focus on foods that keep them there, and in doing so, starve their gut flora. The glucose blunting/insulin sensitizing effects of RS are mainly a result of improved gut flora. What Marie has demonstrated, is that even while maintaining a ketogenic state, she was able to tap into the insulin sensitivity provided by the proper care and feeding of gut microbes, courtesy of supplementing with potato starch.

    Without this novel RS source, the only way to increase RS in your diet is through eating loads of starchy RS rich foods (cold potatoes, RS wraps, green bananas). Even though we’ve taken heat for using purified starches as an RS source, this shows that even staunch supporters of low carb lifestyles can also benefit from increased gut microflora and remain in ketosis if desired.

    I think that most people doing LC/VLC are doing it for the wrong reasons and probably shouldn’t be, but just like we take other supplements, maybe using raw starch as a supplement for gut health is a good way to make low carbing a bit healthier.

  5. Richard Nikoley on September 25, 2013 at 12:23

    “of course honey must be replaced with splenda or erythritol… flavor with vanilla”

    Entire. Point. Missed. Totally. Over. Head. Smack. Forehead. Wow.

    Wooo…. Oh, nevermind.

  6. marie on September 25, 2013 at 12:27

    Wooo, a ketogenic meal should have a ratio of Fat:other (other of course being carbs+protein) of 4:1 if you are to stay in ketosis. Some meals can go down to 2:1 if you use coconut oil or MCT.

    Heres’ the break-down for this yogurt+honey :
    Greek yogurt 1.5c : 16g fat = 144kC
    22g protein+10g carb =128kC
    +
    3tsp honey 23g carb (even counting all of it, though 1/2 fructose won’t contribute directly to glucose effect) : 92kC

    So this combo has 33g carbs and 22g protein with a ratio of fat calories to others of 144:220, which is upside down. Even without the honey, it’s 144:128, which is close to 1:1. Not good.
    Having too much protein in any meal is where a lot of people have trouble maintaining ketosis, that’s why he’s not allowed yogurt.

    Now, about the fasting, yes that’s exactly why I do it. I need a fast way to drop into ketosis, so depleting my glycogen stores (which are never entirely replete anyway) is a good way to do it.

    That doesn’t change the fact that I get a very strong physiological insulin resistance when I do that, as I should.
    That reversible insulin resistance makes it Harder to deal with any glucose.
    So I’m not sure where you’re projections/expectations are coming from, but if your’e thinking that being in a fat burning state will make a big difference to upside down ratios, let’s think of the actual numbers involved : I’m only burning about 90kC/hr when awake. Even if that’s all fat, adding it to my ‘meal’ won’t do enough to fix things.

    I agree though that this particular meal, given the numbers I had calculated, had a good chance of letting me drop back into ketosis quickly, since I was fasted. That’s why I kept testing :)

    Anyway, no matter anyone’s expectations, even my own, there’s nothing like trying it out in a controlled way to figure out effects.

  7. Richard Nikoley on September 25, 2013 at 12:36

    “Anyway, no matter anyone’s expectations […] there’s nothing like trying it out in a controlled way to figure out effects.”

    A…hem…

  8. marie on September 25, 2013 at 13:13

    Richard, maybe should put here some of the controls? That would take away any hypothesizing.
    I’ve summarized from the long emails :

    This meal in this subject, me :
    Before daily RS supplementation and without taking RS with meal : avg.ΔBG = 38 points (eg. peak at 118mg/dl if pre-meal BG was 80mg/dl)

    Same situation as above, but tested in fasted Ketosis : avg.ΔBG = 56 points (there’s the effect of physiological insulin resistance from fasted ketosis; it’s more pronounced the higher the glycemic index of the food and the amount of carbs, eg.cooked potatoes are bad that way).

    There are more controls than experiments actually, if anyone’s interested (a la “did you try x”) just ask… :)

  9. bornagain on September 25, 2013 at 15:35

    @wooo. Yadda, yadda, yadda. Yawn…

  10. BigRob on September 25, 2013 at 16:11

    @wolfstriked don’t come with that baking soda shite. No medical evidence whatsoever.

  11. marie on September 25, 2013 at 17:53

    Wolfstriked,
    of course I appreciate any attempt to help, ignore BigRob, he’s a big bear! I’ve looked into many therapies, there are so many out there that I have to stick to looking at the ones that have significant research behind them. Meanwhile though, anything that normalizes whole-body responses has got to be a good thing, so I certainly don’t see any harm in taking BS if one sees a difference.
    Thanks for the well wishes.

  12. bornagain on September 25, 2013 at 18:08

    Richard, please make your own meal replacement shake (potato starch, kefir protein, liver powder and coconut) and sell it online. You could outsource distribution to Sisson, no?

  13. Richard Nikoley on September 25, 2013 at 18:46

    Bornagain

    It’s not that it’s a bad idea, especially if the PS is “re formulated” such that there’s big value add as you suggest. Then, surely a lot of people won’t mind the steep markup for something they can get pretty cheap.

    It’s just not my style right now. I just got loose from a business managing people & resources and clients and such. Service business but not a lot different as I’d be outsourcing everything, manufacturing nothing.

    I have my sights on using my time & energy elsewhere for now.

    OTOH, if someone wants to develop a product and use me or FTA for branding, and all’s I do is some silly videos and interviews, we’ve got a deal.

  14. Stark Brandstone on September 25, 2013 at 19:00

    You sign off on the formula and get a cut. I’ll get it made.

  15. Tatertot on September 25, 2013 at 22:46

    Somebody will be selling an RS mix one day soon, I predict. It’s almost guaranteed it will be made of Hi-Maize. Most of my drive for getting this info out was to beat them to the punch. I’d love to see the info on how to get RS from food in meaningful quantities and potato/tapioca starch out as widely as possible. Sadly, most people won’t pay attention until they see commercials for flashy products and big jars of it at Sam’s Club.

  16. Raphael S on September 26, 2013 at 00:17

    @Marie
    Isn’t the fat:proteins+carbs (4:1) ratio an average indication of what should get most people into ketosis rather than a binary minimum?
    Also, the 4:1 ratio is meant for fat:proteins+(absorbable) carbohydrates, while your concoction adds a source of non-absorbable carbohydrates (RS/PS).

    In your opinion, is the RS/PS ‘improving’ the ratio in terms of how many absorbable-carbs your body can handle appropriately without hitting high blood sugar peaks? Or is it a substitutive effect (less absorbable for more non-absorbable carbs) leaving the body with lower overall glucose load to handle?

    When I get my hands on a blood glucose meter I will happily to add myself to the growing list of N=1’s :D

  17. yien on September 26, 2013 at 02:04

    “Richard – I didnt miss the point…Just toss the honey”

    Apart from wooo missing the point, again.

    I’d also throw out the benefits of:
    -enzymes being present in honey (unlike pretty much any other sweetener)
    -its synergy with starch (for example, as a substrate of honey diastase)
    -its bacterial impact

  18. bornagain on September 26, 2013 at 05:35

    @woo. Yadda, yadda… yawn.

  19. marie on September 26, 2013 at 07:50

    Wooo,
    I enjoy your blog as you know and I think you have a lot of information and a fun writing style, but you’ve missed the point on this one.

    It’s not about what is or isn’t useful in a ketogenic diet. Dad’s situation is just the motivation for a series of experiments that involved RS. Since a lot of people are interested in it for the BG control, I’m sharing those that are relevant here.

    It’s about the fact that with honey and in a state of physiological insulin resistance, which makes the BG response to a glucose bolus bigger, RS still managed to bring down the BG response.

    You can try to explain that away any way you like if it weren’t for the fact that in the same state in the same subject, me, without RS the BG response was much larger.
    That’s what controlled experiments are about.

    But you know that, so I’m thinking you’ve been skimming and did not notice either the phrase in the post about that or the data in the comment about the controls or any of the previous posts which set the context, that context being about RS and how it affects BG.

    And that would be o.k., if you phrased what puzzles you as questions.

    As for your advice on yogurt, again, if you’d seen previous post you’d see they tried yogurt with coconut oil – to disgusting effect. The oil of course makes solid chunks in the cool yogurt so you get little bursts of grease in your mouth. Some find that fine, some don’t. Di gustibus… I appreciate you may be trying to help with advice like that, but it didn’t work already.

    As for conditions on his diet, I wouldn’t argue with his doctors on that, it’s seeing real success. The second round of chemo was more effective than the first and he also tolerated it much better, little nausea.
    They want him at 80% fat for this adjuvant therapy, they get 80%.

    This all started with just the idea to add RS itself to his diet, for the immunological and gut-healing effects, making sure he doesn’t drop out of a very strict ketosis. That’s been done.

    Let me redirect again though, lest we veer off into keto land, the experiment shown here, no matter it’s motivation, is to demonstrate what can happen, even with fasted insulin resistance, if you’re taking RS for a while.

    No matter how I started, it ends up putting RS through it’s paces. Done in normal state, done in dietary ketosis (you missed the ketogenic liver dish earlier! and me so proud of my cooking skillz), done in fasted ketosis….done after long term daily RS….

  20. marie on September 26, 2013 at 08:03

    That was the long answer, because I can accept where you’re coming from.

    Here’s the simply sufficient answer: you have “before and after” data (ie. without RS and with RS) in the same subject in the same state.
    Everything else is handwaving.

  21. Richard Nikoley on September 26, 2013 at 08:14

    “Everything else is handwaving.”

    Pay attention to that, everyone, partout. This is my main beef. As I have attempted to explain in posts, the LC bashing is about THAT, and not what you typically see. I have zero issue with LC or ketogentic being effective THERAPEUTIC interventions for many things that ail. Neurological issues, diabetes, other metabolic issues, fat loss (to a point, I think, as is my own experience too), etc.

    It’s the idea that since LC is a good “drug” it’s tantamount to a “healthy lifestyle” for all and if you criticize its BROAD application like that, you’re a low carb basher.

    Nope, I’m not giving anyone that argument. I have my Ps & Qs well in order, shit in one sac, yada yada.

  22. Merr on September 26, 2013 at 08:40

    “It’s the idea that since LC is a good “drug” it’s tantamount to a “healthy lifestyle” for all and if you criticize its BROAD application like that, you’re a low carb basher.”

    I know, right. It’s tiring. I’m fascinated that so many people act like they know it all. Just try shit out and see if it works. What’s so threatening about trying shit out? You think you’re gonna die of a stroke because you drank 8 ounces of water with a couple tablespoons of potato starch mixed in? Jeezus.

    I’ve been doing potato starch for 3 weeks or so and see no differences one way or another. Same thing happened with Vit D supp and Vit K over a 6 or 12 month period. Adding bone broth – huge deal for me. Liver too.

    My personal experience with RS and Vit D/K supplements doesn’t mean the same supplements won’t make a huge difference for others.

  23. Tatertot on September 26, 2013 at 09:08

    If my spidey sense is correct, I think that one day supplementing with RS will be on par with taking D3 and K2. People will be doing it and not even remember why. It will become a staple of paleo, a gimmick for SAD (Healthy RS-rich muffins!), and it will be a household word that sells products. The CW advice will change from ‘eat healthy whole grains’ to ‘eat lots of RS rich foods’.

  24. Merr on September 26, 2013 at 09:26

    Let’s hope not, Tim. But you’re probably right.

  25. ChocoTaco369 on September 26, 2013 at 09:34

    All of the constant testing and incredibly careful food preparation and fat:protein:carb ratio calculations necessary to maintain ketosis is just more proof that the human body does not want to be in ketosis. It will do everything in its power to fall out of ketosis. The fact that it takes so much planning and preparation to maintain that lifestyle is proof positive for why it should be avoided in the overwhelming majority of us. It exists for one reason – to help sustain our brain function in times of starvation. Why anyone outside of extreme medicinal measures would want to mimic the metabolism of a starving human being is beyond me.

  26. BigRob on September 26, 2013 at 09:43

    @marie

    Have you tried coconut butter mixed in with the yogurt instead of coconut oil? Being a whole food, I bet it would mix better and it wouldn’t be greasy.

    By comparison coconut butter has 5 grams less fat per tablespoon than coconut oil. 1 gram of usable carbs.

  27. MsMcGillicuddy on September 26, 2013 at 11:13

    Can I restate this is in way that even a caveman can understand it?

    Yes, there are multiple ways to remain in ketosis, but they all involve eating a low carb diet, either through restricting carbs only or all macronutrients (which in effect is low carb and low fat and low protein LOL)

    What Marie has demonstrated, is a way to not severely restrict carbohydrates, yet remain in ketosis, through supplementation with resistant starch and maintenance of an appropriate gut flora.

    Do I have this right?

  28. MsMcGillicuddy on September 26, 2013 at 12:03

    This will bump Chia off the news LOL

  29. marie on September 26, 2013 at 12:18

    BigRob, thanks, that’s constructive.
    Maybe if can do that plus RS, we can get the honey in there. The honey’s the thing.

  30. BigRob on September 26, 2013 at 12:24

    @marie thats what I was thinking as well. Increase the fat, but still be able to solve the pleasant taste issue with the honey and RS.

  31. marie on September 26, 2013 at 12:37

    MsMcG, pretty much, though a person might drop briefly out of it.

  32. marie on September 26, 2013 at 15:51

    BigRob, merci cher. With him needing so deep/strict a state, it takes a multi-pronged approach to figure out some pleasant variations for him. The RS is maybe an additional tool for that.

    I thought I’d share here because of course most people don’t need that strict a regimen, so anything that improves their BG response is useful. RS improves the BG resposne. No matter what metabolic state. That’s the key point in the end.

    Then, if even VLC people want to use it to improve the health of their gut biome (for all the benefits associated with that) well they should know they can use it too. RS alone anytime, or, after some weeks of RS they can even have some readily digestible carbs as well, since the RS helps so that the other carbs don’t cause too much BG rise.

  33. golooraam on September 27, 2013 at 08:48

    ok, I said this a few months ago and didn’t follow through… I did one day, got farty, then stopped

    but I am going to supplement each of my days for the next few months with 3 tbs of potato starch
    I have plenty on hand and started last night – even had 3 tbs with some unsweetened cacao with my breakfast of raw scallops and avocado

    I eat paleo mostly, minimal dairy, mostly seafood but I love my pastured pork chops and steaks as well

    I do mostly chin-ups and shoulder presses and tons of walking and am working on losing 30 lbs of bf over the next 3.5 months

    any advice would be welcome – I don’t try to actively eat keto – I do take MCT oil, and I eat protein to fill – usually 7-12 ounces, but I never do something like eat a pound of skinless chicken breast or something equally as carboard like

  34. grace/DrBG on September 28, 2013 at 17:08

    i like shirataki/konjac/glucomannan, mung bean and yam noodles…. i like the protein, sliminess, low or zero glycemic load/index and FIBER. they contain BOTH soluble NSP and resistant starch

    see page 75

    the Asian tubers with the highest protein are also the highest amylose %content. we didnt evolve eating RS alone; it was always in conjunction with other starches that exhibit viscocity. The most slimy the better?

  35. grace/DrBG on September 28, 2013 at 15:28

    marie,

    Good luck with your father and his treatments. I love your posts and your experiments. Thanks for sharing. What I worry about for cancer patients on ketosis is their mineral status. As I’m sure you aware, electrolyte demands appear to go up in ketosis. I dont understand this but in ketosis, one needs more salt, potassium, mag and zinc. In cancer (or any condition) mag, zinc and other minerals are typically low, if not completely depleted. there are many subsequent immune,mitochondrial, and gut deficits associated with mineral deficiences.

    Are you and your father aware of the functional and integrative medicine oncological approaches to synergistically strengthen immunity and fight cancer? This from Jefferson in Philly.

    http://jdc.jefferson.edu/do/search/?q=integrative%20ppar&start=0&context=37312

    To me, RS is fiber though no one is calling it fiber…. Pysllium also blunts glucose and insulin spikes. Both feed the gut microbiota. To me, it would be interesting if your personal experiment included a synergy arm (psyllium + RS) and one psyllium arm.

    http://www.ncbi.nlm.nih.gov/pubmed/10500014

    http://care.diabetesjournals.org/content/30/5/1039.full.pdf

    grace

  36. grace/DrBG on September 28, 2013 at 17:01

    Pure RS probably will not be seen to lower significant weight alone (especially when combined with gut irritants like glutenful cupcakes or GMO corn Hi Maize or other evil concoctions).

    OTOH psyllium, konjac/glucomannan and other viscous soluble fiber already have been shown to promote significant weight loss… they also improve gut flora and help heal the gut. unlike RS alone, soluble viscous fibers alone promote satiety and thus fix the broken gut hormone brain axis. [my experience is that people who have cravings (food, fat, alcohol, sex, etc) have a broken gut brain axis and a multitude of mineral/vitamin deficiences and usually gut toxins (mercury, pesticides, BPA, etc)]
    http://www.ncbi.nlm.nih.gov/pubmed/16320857

    i suspect this is because advanced hominids have co-evolved with gut microbes that enjoy dining on these… these fibers are shown also to increase endogenous secretion of mucin (which self perpetuates growth of more gut flora) — whether this is an indep effect or symbiotic where the gut flora release mucin growth stimulators, i dunno.

    http://www.ncbi.nlm.nih.gov/pubmed/19605529

  37. grace/DrBG on September 28, 2013 at 17:10
  38. tatertot on September 29, 2013 at 08:54

    @DrBG (Grace) – Thanks for your comments above! Shortly after we started talking about RS here, I realized that it is all about gut flora and that RS is just a prebiotic, like fructans, gums, mucilages, FOS, etc.. and the talk should somehow shift to ‘fiber’ rather than RS. I’m really glad that it didn’t, and I’ll tell you why.

    Firstly, the term fiber is misused by the food police. There is no way a person can get adequate prebiotic fiber by reading fiber labels on foods or in on-line calculators. I remember in my SAD days, being told to ‘eat more fiber’ and end up eating stuff just because it had a high fiber content. The ‘fiber’ in most health-food products is wheat chaff or some other thing that technically fits the fiber definition–bulking agents. Until labels reflect ‘fermentable’ and ‘non-fermentable’ or ‘prebiotic’ fiber, they will remain meaningless.

    Secondly, I think that most people eating a ‘pretty good paleo’ diet get about as much prebiotic fiber as they can from that type of diet–even low carbers. Fruit and veggies are a mainstay of paleo and most people eating this way do pretty good eating a wide variety of fibrous, prebiotic foods. Mostly, they are getting inulin, gums, mucilages, pectin, lignin, beta-glucans, oligosaccharides, and other non-starch polysaccharides (NSP). The trouble is, it is very, very hard to get a total fermentable fiber intake exceeding 5-10g/day by eating these foods.

    I think the missing link is resistant starch. In one of the first papers I read, and one that you linked here last week in one of your comments: http://physrev.physiology.org/content/81/3/1031.full

    “Although NSP resist digestion by intrinsic human intestinal digestive enzymes completely, their intakes do not account for calculated human SCFA production (the “carbohydrate gap”). Some of the deficit may be filled by oligosaccharides (OS), but starch and products of small intestinal starch digestion are thought to contribute the most. This fraction is termed resistant starch (RS). This review aims to examine the relative contributions of RS and NSP to SCFA production in the context of the epidemiological and other data linking complex carbohydrates to improved colon function and lowered disease risk. ”

    and

    “The “carbohydrate gap” is the discrepancy between NSP intakes and calculations of bacterial activity of the large bowel microflora (281) and supports a significant contribution by RS. Individuals in affluent westernized countries may consume up to 28 g NSP/day (22). However, much larger quantities, possibly as much as 80 g, of fermentable carbohydrate are needed to sustain the biomass and account for SCFA production (281), and NSP may only provide 25% of that requirement (139). ”

    and

    “In humans, RS and OS could close the carbohydrate gap (274), but consumption of OS appears to be self-limiting due to osmotic effects and may contribute only 5–10 g/day. ”

    But I think what really sets RS apart is the starch granules themselves. From the same study:

    “Some of the interaction between RS and bacteria appears to be physical, with the organisms adhering to modified or unmodified starch granules (31). This adhesion has been studied relatively little as has the interaction between RS, SCFA, and the large bowel microflora. New technologies for bacterial enumeration will facilitate development of a fuller understanding of these relationships. ”

    This was written in 2000, since then, this unique characteristic of RS has been studied fairly extensively. Basically, probiotic bacteria love RS. When ingested together, or even before ingestion, certain bacteria will adhere to starch granules, etch themselves into the hard outer shell and become encapsulated in a way that they can survive the digestive processes that would normally kill them before reaching the large intestine.

    What I am proposing, is that all other prebiotic, fermentable fibers are important, but without lots of RS, they fall short. Even in studies where people were fed 50g/day of straight inulin there was not near the effect on gut microbes as when fed 30g of RS. However, when fed together, the colonic fermentation sites were shifted to make the entire colon a virtual butyrate factory.

    “Psyllium Shifts the Fermentation Site of High-Amylose Cornstarch toward the Distal Colon and Increases Fecal Butyrate Concentration in Rats”

    From this study: “Cummings et al. (1996) and Phillips et al. (1995) indicated in human studies that an interaction between dietary starch and fiber occurred in large bowel fermentation and that starch was fermented in preference to fiber, suggesting that starch might exert a sparing effect on certain dietary fibers. Also, the present study clearly showed the interactive effects of RS and PS on large bowel SCFA and suggests that it is possible to maintain relatively high butyrate concentration in the distal large bowel by dietary manipulation. The amounts of RS and PS used in the present study were conservative (5 g HAS and 1.5 g PS/100 g in rat diet may correspond to a human intake of ∼25 g HAS and 7.5 g PS intake/d), within the range recommended for adults to consume in a healthy diet. “

  39. tatertot on September 29, 2013 at 09:18

    @DrBG (Grace) – I wanted to split this comment up. I hope I didn’t say anything stupid up there! If I still have your attention, please read on:

    The foods you mention you like (shirataki/konjac/glucomannan, mung bean and yam noodles) are fantastic. I have never had any of them, though. If we all included those foods regularly in our diet, there would be no need for any of this discussion. Same goes for Jerusalem Artichokes, dandelion greens, and chicory root–other great prebiotic foods, that hardly anybody eats–and talk about flatulence! People here think that potato starch makes them fart–try eating a whole Jerusalem Artichoke!

    The whole Potato Starch idea came to me when reading this article:

    In this brief article, the author notes that pigs fed raw potato starch had healthier intestines than other pigs due to the RS. Her conclusion: eat more potato salad. I thought, potato salad my ass–I’m going to eat frickin’ potato starch. Article after article say the same thing. How does eating 1-2g of RS in potato starch equal eating 30g of pure starch? It was right there in front of us all these years.

    Not knowing if people could even eat potato starch, I contacted Bob’s Red Mill. They indicated their product was safe to eat cooked or not. Nothing on the net said anything about it–so I tried it. I started right out with 4TBS a day. I figured if I was going to die from it, I wanted to do it fast!

    Actually, there are hundreds of studies on humans using 40g/day of raw potato starch or other raw starches. It is widely accepted that humans can handle up to about 50g/day with no consequences. So, after about 2 days of ingesting 4TBS/day, I noticed my FBG was 20 points lower, some TMI stuff improved drastically, and I seemed to be sleeping better than ever.

    My next step was to see if I could get this same effect through real food. The only thing at the time I could find with high RS was very green bananas and raw green plantains. I figured out ways to eat these and the effects were the same as the potato starch. This set me on a path to find other foods. I think it is very possible to get 20-40g/day of RS from real foods, but it comes at quite a calorie expense–fried rice, cold potatoes, beans mainly. Or eating less than wonderful food (green bananas). I really liked the thought of using straight starch on a moderate carb diet filled with other fermentable fibers.

    Since I don’t have a test lab filled with eager students wanting to do experiments, I turned to the next best thing–The Internet. I started a few threads on paleo forums that fell on deaf ears and starting taunting Richard here in the comments on his famed ‘Potato Hack’. Luckily for me, he took the bait and in the last 6 months or so we have been able to thoroughly vet the repeatability and safety of ingesting RS rich foods and straight potato starch on blood glucose and other supposed benefits.

  40. R on September 29, 2013 at 06:17

    Tatertot,

    Does tapioca starch need to be unmodified like the potato starch, or will any tapioca starch we find at the store work? I tried to find whether or not this has already been mentioned, but I don’t see it.

  41. tatertot on September 29, 2013 at 08:19

    @R – Tapioca Starch and Tapioca Flour are the same thing. It is made from the tuber of the cassava plant. When fresh, these tubers have high levels of cyanide. To make the starch/flour, they wash, grind, and filter out the starch–just like with potato starch.

    The only product that won’t work is tapioca pearls–those are made from cooked tapioca starch.

  42. R on September 29, 2013 at 08:33

    Oh, okay, so the way it’s made, it’s naturally raw. Thanks for the info on tapioca starch/flour being the same thing. You know that would have been my next question once I went to the store and only found tapioca ‘flour’.

    BTW, I really appreciate your help, and you and Richard getting this information out there and helping others. Thanks guys!

  43. tatertot on September 29, 2013 at 09:33

    OK, one more, just had my second cup of coffee…

    I am not in the least deluded into thinking that eating a paleo diet is anywhere close to eating like paleo people really ate. I’ve seen the coprolite studies: lizard scales, bird feathers, mouse bones, plant pollen, and fermentable fiber up to 100g+ per day. No way our guts–even in the best case–look anything like theirs.

    But I do think we can do a better job of the modern paleo diet. Most people look at paleo as a fancy low carb diet and quickly ditch all rice, potatoes, and beans for certain ‘toxic’ effects or their high carb counts. This is good for some weight loss, but does nothing for the gut.

    I have convinced myself that our true ancestral diet was full of RS no matter where our ancestors lived, with the exception of a few outlier groups. All through Africa and Asia there are tubers and fruits full of RS. Taro, cassava, plantain, bananas, sago palm, etc… As people migrated north and east, there was still RS–cattail roots, potatoes, plant pollen, etc… It wasn’t until the advent of agriculture that we stopped eating so much RS.

    I may be wrong, but I think that we are going to find that a diet lacking RS, even with plenty of other prebiotics, is substandard.

    Tatertot out!

  44. tatertot on September 29, 2013 at 10:06

    @DrBG – Just spent a few minutes clicking all the links you provided above. I really liked the thesis on uses of underutilized tubers for starch sources–kind of proves my point about things traditionally eaten, but not so much now.

    There were several studies on glucomannan and psyllium. Both have similar effect on BG and may be useful in obesity, but how would one get these things naturally?

    There’s no way a person could ingest 5g/day of psyllium husk fiber unless they sat in a Plantago http://en.wikipedia.org/wiki/Plantago field and did nothing but eat the seed husks.

    To get any meaningful glucomannan, one would need access to the konjac plants or chew on pine trees. http://en.wikipedia.org/wiki/Glucomannan

    These two items are almost exclusively supplemented, in studies and real life. At least with RS, it’s easy to get high dose from real food, and supplemented cheaply and easily when desired.

    It’s funny that when people read a story of potato starch fed to pigs, they jump to the conclusion: “eat more potato salad”, but when you read a story on psyllium husk being good for you, you make the conclusion: “buy psyllium husk supplements” and not “go eat a bunch of seed husks from the psyllium plant”.

    Anyway, thanks again for joining in– your knowledge on gut flora is very impressive and I have thoroughly enjoyed your blog! If anyone hasn’t seen it, it’s: url-removed/

  45. judyb on September 29, 2013 at 12:02

    tatertot,

    You said: “At least with RS, it’s easy to get high dose from real food”

    You seem to have changed your mind about our ability to get enough resistant starch through real food alone and the effect of reheating on resistant starch. Could you please explain your reasoning?

    Thanks,
    judy

  46. tatertot on September 29, 2013 at 16:01

    @judyB – I have changed my mind a bit recently…the part about starch that forms when food is cooled retaining it’s RS when reheated I just learned about in the last few weeks.

    I’ve always thought it very possible to get 20-40g/day with just food–but it takes a bit of forethought and planning (cooking and cooling/drying, etc) and involves eating non-‘paleo’ foods (beans, rice, potatoes). Compare that with glucomannan and psyillium husks–those need to be supplemented or eaten in special foods made with them.

    I like the ease of potato starch as a supplement when you haven’t eaten many RS rich foods for a couple days.

  47. judyb on September 29, 2013 at 16:50

    “I have changed my mind a bit recently…the part about starch that forms when food is cooled retaining it’s RS when reheated I just learned about in the last few weeks.”

    Thanks, tatertot. Could you please explain why you have changed your mind and what it is you learned about in the last few weeks that led you to that conclusion (i.e. that RS remains even when reheated)? I, too, like the simplicity and ease of potato starch as a supplement, but like you, I think most should be gleaned from regular diet.

    Thanks,
    judy

  48. tatertot on September 29, 2013 at 18:28

    Mainly, these two studies. We talked about it in some of the comments—I know, hard to follow! I told Richard I’d do a write up and an addendum to the master RS list…

    http://lib.dr.iastate.edu/cgi/viewcontent.cgi?article=3817&context=etd&sei-redir=1&referer=http%3A%2F%2Fwww.bing.com%2Fsearch%3Fq%3Dresistant%2Bstarch%2Bin%2Bfried%2Brice%26pc%3DMOZI%26form%3DMOZSBR#search=%22resistant%20starch%20fried%20rice%22

    “After cold-storage of the steamed rice at 4°C for 24 h followed by stir-cooking for 3 min without corn oil, RS contents of japonica, indica, and waxy rice increased to 13.6%, 12.2%, and 7.9%, respectively. Stir-frying the cold -stored rice with corn oil further increased RS contents to 15.9%, 16.6%, and 12.1%, respectively. Stir-fried indica and japonica rice showed significantly less RDS (p< 0.05) than the waxy counterpart. Stir-fried rice of all varieties displayed significantly larger RS contents (p<0.05) than steamed and pilaf rice. The larger RS contents of pilaf rice compared with steamed rice suggest the formations of amylose-lipid complexes formed during cooking."

    and http://www.ncbi.nlm.nih.gov/pubmed/3812341 abstract only, but I have a copy of he whole study on pdf…

    "Starch from freshly cooked potato was well digested, only 3% being recovered; however, 12% from cooked and cooled potato escaped digestion in the small intestine. Digestibility of starch made resistant to alpha-amylase by cooling improved on reheating. Overall, 9, 18, and 14% of total carbohydrate fed was recovered from freshly cooked, cooled, and reheated potato, respectively."

  49. marie on September 29, 2013 at 22:15

    grace/DrBG, thank you very much!
    I lost this thread sometime yesterday, I’m glad I checked directly again.
    We’re very lucky with his doctors, the team leader is a family friend and amenable to discussion. He studied in Germany and has contacts there still, so he got on the ketogenic aspect right quick earlier this year and has been leading it.
    I did worry about minerals early on and they’ve been monitoring those levels as well, more frequently before and after chemo. He’s on a few supplements, magnesium, potassium, zinc, selenium. Also, coQ10, but not during the chemo. He’s replete for vitamins from his diet, other than D3 which is supplemented.
    Now I’m passing that comprehensive approach jefferson article on to his doc, thank you!

    Also, for the other fibers (yah, I think of RS as ‘fiber’ too :) ), psyllium irritates the heck out of him, he used to take it long ago. Meanwhile, with the fatty diet and all the leafy greens….and o.k., two operations removing a total of 30cms (a third op was only on the liver where it metastasized) he goes 2-3 times a day.
    However, does the synergistic idea maybe work with inulin too?
    Parents get a lot of that in traditional way in that part of the world, dandelion greens, garlic etc. I’m going to study the links you’ve given and also on your site. Tatertot has also supplied some related info.

    No TMI effects with the RS, thankfully!, he went from 1T/day to 2T/day and is holding fine a month now. Mom started taking it too, apparently because ‘precaution doesn’t hurt’. She’s been trying to also eat what he has to, in order to make it easier, but has been known to sneak ice cream over the summer. Heh, I should get her to also take a spoon of RS with it and use the stix, then we’ll have an n=2 on returning to keto :)

  50. marie on September 29, 2013 at 23:22

    Raphael S,
    “When I get my hands on a blood glucose meter I will happily to add myself to the growing list of N=1′s :) ”
    Do!
    See note just above about ice-cream. If you’re keto, I’d sure like to know how that one works with RS. I’m thinking custard (fatty ice-cream) with 2T RS would be best, assuming you’ve taken RS for a few weeks. I haven’t got to it because it’s just junkfood, but would be good to know from the RS perspective (and I bet lots of people miss ice-cream).

    Which brings me to your other questions : this is a medical keto diet, it is tough, gotta be 80% which maintains deep ketosis, not namby-pamby ‘trace’ levels nor even ‘light’, which rarely are maintained anyway (at those levels, you’re drifting in and out of ‘ketosis’, the predominantly ketone-supplied energy stated). This is because not only do they want him to drive consistently low glucose levels, but are trying to keep IGF-1 to a minimum so as not to provide cells with growth stimulant.

    So yes, for most people who don’t have to be in that state constantly and deeply, 4:1 is not binary…nor binding :)
    Moreover, using MCT oil and/or coconut oil really helps, as does Not gorging on protein. A certain liver keto-meal for dad, cooked in coconut oil, is ‘only’ 2:1 ratio.

    Also, If they are even slightly hypo-caloric, they can stay in ketosis with lower ratios, as long as they keep the carbs below ~20-50gms (exact depends of person).
    Since many people use ‘ketogenic’ diets to lose weight, the ratio needn’t be so restrictive.
    It also won’t drive insulin resistance (natural/physiological) quite as much as deep ketosis does or fasting does for 48hrs. That’s when I get my insulin state (resistant) and numbers to match dad’s (FBG, ketostix), so that’s the state I need to test.

    It relates to everyone else & the RS discussion in that it’s an extreme challenge to manage any glucose bolus when you’re that insulin resistant. You look at sugar, you get a spike. No, no woolicious chocolate chip cookie can sneak by.
    Similar resistance is why people normally have to eats carbs for 3 days or more before taking an OGTT if they’ve been VLC or keto for a long time, or else they bias their score.

    For RS tolerance alone, I tested both fasted and fed ketosis, just in case any synergies of RS with keto food.
    As you saw, BG and ketostix never knew any RS was ingested and that was with 4T of the stuff (and once, I accidentally took 6T….tatertot saved me from even more! – still no TMI btw).
    So to answer your last question, yes, I do think that the RS, fermented to SCFA, is positively affecting the keto-ratio of food, since apparently any minority glucose-capable component is not registering at all.
    But it’s not likely to give a whole lot from a couple of Tbsp, eh?
    I’m thinking the mechanisms for blunting the BG response are likely short and long term, combinations of physical ‘diluting’/slowing and SCFA action directly on glucose metabolism pathways.

  51. yien on September 30, 2013 at 01:08

    I like Dr BG’s seed, weed, feed concepts for gut bacteria.

    I think dirt, honey, and rs are key components. In particular, honey’s role as a key antibiotic for bad bugs, and probiotic for good bugs has an undervalued role.

    5-16% of Hadza diet is honey, and has been linked to gut and brain evolution (more so than meat and fat, especially now that ETH is debunked).

  52. judyb on September 30, 2013 at 09:33

    Thanks for the patient explanation, tatertot. I somehow missed the comments you refer to. The ones I saw were the ones indicating you had changed your position somewhat, and of course I was curious as to why.

    judy

  53. Tatertot on September 30, 2013 at 10:05

    @judyb – lol, there are like 30 discussions going on simultaneously right now in the various RS posts…

  54. Ggg/DrBG on September 30, 2013 at 18:11

    Marie– let me consolidate thoughts

    Tater– revolutionary thoughts! I like all 30 discussions but I’m glad to see the evolution of thoughts toward synergy of all the components in ancestral hominids — honey (thx Yien), cattails, pollen, dirt, prey entrails (yes I’d eat guts if I was hungry), ancient tubers (NSP + RS). Thank you for increasing the volume on the importance of the gut and immunity

  55. marie on September 30, 2013 at 18:27

    Thanks Grace. And oh btw, I do eat guts even when not hungry (!), in a soup with other organs, it’s a Greek (and Italian) delicacy – the whole country indulges on Easter and on certain feast days during the year. Here in Rochester can’t find them of course, but there’s a little Italian restaurant that at least makes tripe. Definitely an acquired taste though, kinda like the famous Hagis ;)

  56. La Frite on October 1, 2013 at 01:32

    Et bien Marie!? Et les “Tripes à la Mode de Caen” ?? C’est d’la bonne tripaille normande ! … nothing Greek in it … :D It’s been a while since I went back to the Calvados area but man, do they have nice foods there!

  57. marie on October 1, 2013 at 07:53

    Ahaha, but of course! It’s a taste that transcends borders :D
    Meanwhile, thanks to mémé, even though she wasn’t exactly from Normandy, I suspect some rather pampered taste buds coming from both sides of the family! And yes, do they have nice foods there, not to mention that wine… ;)

  58. Eric on October 11, 2013 at 17:04

    Wow, I’d heard of RS before but never bothered following up because I live keto. Might have to give it a try now. That being said, there is a big keto discussion group on FB, we do focus on athletics rather than medical intervention, but you might pick up some helpful info on ketosis. Some of us eat all kinds of ice cream, brownies, yogurt, etc. and remain deep deep in ketosis.
    facebook.com/groups/RunKeto/

  59. Bernhard on February 2, 2014 at 04:40

    @ Wooo Just one question (please spare the worn out answers – it’s the neurons,…etc.):
    What! is a seizure?
    What! is a seizure?
    What! is a seizure?
    Pacem.

Leave a Comment

You must be logged in to post a comment.