Don’t blame asparagus and mushrooms for what soda and potato chips did to you

“Carbohydrate quality and human health: a series of systematic reviews and meta-analyses” (Reynolds et al., 2019)

Essential notes:

-this article was about carb quality not quantity

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-fibre is complicated. You can say soluble & insoluble, but really there are many different types and all of them still aren’t even clearly one or the other.

-a low carb diet can also be a high fibre diet. In fact, I guess since my own diet has a lot of low carb (LC) plants, I was shocked that they considered 25-29 grams “high fibre.”

-again, a high fibre diet doesn’t have to be a high carb diet

-while I don’t doubt the effects of various fibres per se, other components of these foods may also contribute to their benefits (vitamins, minerals, other nutrients, etc.).

-fibre will not end the obesity epidemic otherwise Metamucil would’ve ended it years ago. The only fibre supp I’ve recommended is Bimuno, and that’s for GI problems not weight loss.

Is fibre *essential?*

Essential for what?

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Almonds, asparagus, broccoli, Brussels sprouts, cabbage, chives, endive, escarole, leek, mushrooms, onion, peppers, scallion, spinach, etc., etc., etc.

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Mistimed food intake and sleep can mess you up.

Mistimed food intake and sleep alters 24-hour time-of-day patterns of the human plasma proteome (Depner et al., 2018)

or

Why you need to be mindful of circadian rhythms Every. Single. Day.

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I once heard a joke – “I wish going to the gym was like going to high school. Once you get your diploma / get fit, you never need to go back” (or something like that). Unfortnately, circadian rhythms also fall into this category.

This study examined a pretty extreme model of circadian misalignment. Basically, they took a bunch of measurements during a normal day & night, then allowed the subjects a brief nap during the afternoon the next day, kept them up all night, then took more measurements during daytime sleep and evening wakefulness.

Looking at the bottom graph should tell you all you need to know about the importance of daily circadian entrainment. While some circadian clocks can maintain a normal rhythm for a little while after a period of circadian misalignment, look how quickly melatonin increased during the daytime in circadian misalignment. This didn’t really bode well for sleep as it declined by almost a full hour…

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The role of the ‘biome in insomnia, circadian disruption, and depression

Everything is connected! (Li et al., 2018)

Good sleep and mood are important for health and keeping active. Keeping active is important for sleep, mood, and health. Good health is important for sleep, mood, and physical activity.

“There is considerable evidence showing that the gut ‘biome not only affects the digestive, metabolic, and immune functions of the host but also regulates host sleep and mental states through the ‘biome-gut-brain axis… the ‘biome and inflammation may be linked to sleep loss, circadian misalignment, affective disorders, and metabolic disease.”

The only gut products I’ve ever really recommended are Bifido (eg, something like this or this) and GOS… and start with a very low dose.

Epidemiological studies have shown the infinite inter-connectedness of all of these conditions. Many people with sleep problems also have IBS. Many people with anxiety have sleep problems. Many people with IBS have mood disorders. Etc., etc., etc…

The authors of this recent review have suggested 3 main pathways in which this might occur.

  1. immunoregulatory pathway: mediated by cytokines, PGE2, etc.
  2. neuroendocrine pathway: enteroendocrine cells which secrete hormones that directly influence the HPA axis and the CNS.
  3. vagus nerve pathway wherein sensory neurons of the intestinal myenteric plexus respond to the ‘biome to affect gut physiology and signal to the brain (tenth cranial nerve and all that jazz)

Importantly, the CNS can also regulate the ‘biome via these pathways. Everything is connected! If something isn’t right with your health, these are probably the places to look.

The main 2 ‘biome inhabitants are Bacteroidetes and Firmicutes. Firmicutes (like Acidophilus) have been associated with obesity. Sometimes. Bifido is neither, it’s an Actinobacteria. Circadian misalignment and sleep deprivation have been shown to influence the relative abundances and ‘biome metabolites (eg, Davies et al., 2014). Jet lag increases Firmicutes which is reversed upon recovery. Whoa.

Bifido supps have been shown to improve emotional and cognitive indicators, the stress response, and anxiety in people with IBS (Plaza-Diaz et al., 2017)… and bifido is reduced in people with chronic fatigue syndrome.

Stress increases gut permeability, bacterial translocation, and bloating which is associated with sleep disorders because of course it is.

In mice, at least, these can be corrected by fixing their ‘biome…

Effects of the probiotic bifidobacterium infantis in the maternal separation model of depression (Desbonnet et al., 2010)

Not too surprising as 90% of your serotonin comes from chromaffin cells in your gut and bifido actually produces GABA. Bifido are reduced in patients with depression (correlation =/= causation, but this is highly consistent in a variety of contexts).

Sleep loss, circadian misalignment, affective disorders, metabolic disease, the ‘biome, and inflammation. They’re all connected! If something isn’t right, these are probably the places to look.

That’s all for now!

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Circadian clocks and insulin resistance

If nothing else, this article had great figures (Stenvers et al., 2018).

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Clock gene mutations, exposure to artificial light at night, disturbed sleep, shift work, social jet lag, etc., are factors that contribute to circadian disruption and insulin resistance.

Figure 1.

Figure 2. Clocks, clocks everywhere!

The human circadian timing system is not exactly 24 hours, therefore, it needs to be entrained every day. Environmental light is the most important zeitgeber for setting the central pacemaker, while that, food intake, physical activity, etc., contribute to setting peripheral pacemakers.

In humans, tissue-specific glucose tolerance, insulin sensitivity, and thus nutrient partitioning depend on the time of day. For example, glucose tolerance is higher in the morning than at night. And the effects of insulin on fat storage are greater at night than in the morning. Worded another way, adipose stores more fat with less insulin in the evening compared to morning.

Figure:

Some of the most basic findings to support the role of circadian rhythms in insulin sensitivity come from rodent studies: damage to the central clock (SCN) results in insulin resistance within weeks independent from food intake or physical activity. In humans, observational studies on shift workers have been supported by intervention studies on intentional circadian disruption which show, collectively, insulin resistance and various aspects of metabolic syndrome.

Figure: muscle clock

Entraining and capitalizing on the muscle clock has been largely under-rated until very recently. Entrain the muscle clock indirectly via SCN with light in the morning and more directly with food intake and some sort of physical activity. Capitalize on this by front-loading calories, optimize by combining all 3 (and maybe more in the future, as more is uncovered).

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Consequences of circadian disruption on neurologic health and the influence of nutrients & food factors

“Impaired sleep-wake cycle, the most robust output rhythms of the circadian system, is significantly affected by neurodegenerative disorders, may precede them by decades, and may also impact their progression” (Videnovic and Zee, 2015).

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^^^ that’s the ‘safe’ way of saying circadian disruptions likely cause neurodegenerative disorders. And if you have one or more of these disorders, addressing circadian rhythms should be first line therapy.

Sleep loss itself is a risk factor for cerebrovascular events, likely due to alterations in autonomonic nervous system or immune homeostasis, and sleep disorders are common in stroke victims.

The robust circadian variation in cortisol declines in aging adults, and the degree it is lost is associated with cognitive impairments and crappy sleep.

Parkinson’s Disease: circadian variation in symptoms — it’s almost always worse in the evening regardless of when dopaminergic medications are administered. Dopamine itself is a circadian hormone. All of these suggest circadian rhythms should be part of the treatment program. Indeed, 90% of patients report impaired sleep and reduced daytime alertness.

Alzheimer’s Disease: one of the big ones. Circadian dysregulation has a major impact on quality of life and represents a major reason for institutionalizing these patients. That’s expensive. Preclinical studies have suggested this is a function SCN atrophy (the master clock) and impaired pineal function (source of melatonin). Those two observations argue largely for the role of circadian dysregulation in the pathology of Alzheimer’s disease. No one is talking about light therapy and blue blockers for Alzheimer’s patients. No one.

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The three diet studies everyone is talking about (DiReCT, PURE, and Virta)

None of them have particularly great study designs, but that hasn’t prevented the buzz. Here is a summary of the strengths and weaknesses.

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Tl;dr:

DiReCT (Diabetes Remission Clinical Trial): randomized. N=306, 1-year. 3-5 months ultra-low calorie weight loss diet (~850 kcal/d) followed by 2-8 weeks of guided food reintroduction and then weight maintenance counseling.

PURE (Prospective Urban Rural Epidemiology): n=135335, 7.4 years follow-up. The dreaded Food Frequency Questionnaire, although they were comparing lowest with highest quintile… I think I can accurately recall if I’ve had more than 5 servings of something today or none in the past month. They’re not asking what I had to eat August 25th 2017 for lunch.

Virta: low carb, calorie restricted. N=262, 1 year long. They had a weight maintenance control group, which is good, but it’s not hard to beat a weight maintenance control group with any diet. A low fat comparison group would’ve been more informative.


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Circadian clocks, entrainment, and health

Summary of a presentation by Orie Shafer titled “Circadian timekeeping and entrainment in neuronal clock networks.”

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From the classic Wever study, which put participants in underground dungeons to study circadian rhythms in the absence of sunlight…

and showed there are multiple inputs, both external and internal zeitgebers.

 

 

In this study, in the absence of sunlight, the human circadian rhythm in locomotor activity, bed movements, and rectal temperature was about 25.8 hours:

The study wasn’t perfect, but still cool.

Most people like to simplify and say light is the input, and while it may be the main one, we now know there are also other important inputs such as food intake for the food-entrainable oscillator and exercise for the skeletal muscle clock.

Behavorial rhythms are driven by molecular rhythms. Molecular  clocks are required in small islands of the brain for behavorial, endocrine, and physiological rhythms.” Search for genetically modified models of virtually any clock gene and it’s going to influence a wide variety of processes. Like, circadian rhythms are important for certain aspects of nearly everything. “60% of the time, it works every time” lol

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Deleterious effects of artificial light at night on health and the environment

Evidence summary on how our increasing exposure to artificial blue light is putting us at risk. And actionable steps on what you can do about it.

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It’s not blue light per se, but rather underexposure to natural sunlight during the day and overexposure to artificial light at night (ALAN). Step 1: Do the opposite of that.

 

 

“Bright light occurs naturally as part of sunlight and moonlight and, like all living things on Earth, we have evolved to respond to the daily cycle of light and dark. There is growing concern that the increased exposure to artificial light at nigh is having an effect on our health, wildlife, and the night sky.”

Your eyeballs are pretty awesome. Rods and cones and these crazy cells that respond specifically to daylight. The crazy cells, ipRGCs, respond to light, particularly in the green/blue range of visible and serve, in part, to entrain the central component of your circadian clock in the SCN. This is important and influences many body functions such as sleep, metabolism, immune system, mood, and even certain disease processes.

If you’re more interested in the environmental impact of artificial light (eg, street lamps), book recommendation: The End of Night: Searching for Darkness in an Age of Artificial Light. If you’re more interested in the human effects: Lights Out: Sleep, Sugar, and Survival.

ALAN-induced clock disruption is said to have “flow-on” negative health effect — there’s no “good news / bad news” to this story (it’s all bad news).

Rock hot blue blockers at night. Use blue light filters on your devices like f.lux and Iris. Sunlight during the day; darkness, moonlight, or firelight at night.

Note those spectral sensitivities – we can see more green/blue than any other colors. Maybe there’s a reason for that?

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The carb/insulin model of obesity was tested again, and it fared better this time.

Effects of a low carbohydrate diet on energy expenditure during weight loss maintenance: randomized trial (Ebbeling et al., 2018)

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This is another NuSi study designed to evaluate certain aspects of the carb/insulin model of obesity. Understanding the design of this study is critical to being able to properly evaluate the results.

Very important:

 

1. All food was provided, all the diets were healthy, and most people complied.

2. This was a very expensive study. They used great methods.

Study design: during the “Run-in diet,” everyone followed the same diet (C/F/P: 45%/30%/25%) at 40% caloric restriction in order to lose about 10% of their initial body weight.

Importantly, insulin sensitivity was assessed and this may have influenced what happened next, in the weight maintenance phase. I used to put a lot of weight on this theory — eg, the top 25% most insulin sensitive people will do better on low fat whereas the bottom 25% insulin sensitive people (the most insulin resistant, ie) will do better on low carb — this theory has fared better or worse depending on which study you look at. In this study, it did pretty well.

 

 

In the end, we had 38 people in the entering into the high carb arm of the weight maintenance phase and 43 on low carb.

Remember, they all lost weight on the same diet. Now they’re being fed enough to maintain body weight (low carb, moderate carb, or high carb) and we’re measuring things.

Really exciting stuff!

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The current state of affairs in nutri-Twitter

Rant.

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1) It’s almost as if you’re either:

a red meat-eating 110% keto-advocate

or

you think red meat and a ketogenic diet is harmful.

 

If you don’t say the diet is magical, the zealots will try to trick you into, or outright accuse you of saying it’s harmful.

Further,

 

2. And the protein/kidney debate re-surfaced again recently. To be clear: no studies have shown direct harmful effects of protein on kidney function. The studies cited by KDOQI are observational and on end-stage renal disease. Not mild kidney disease or slightly impaired renal function. If I had ESRD, I’d rather play it safe and not enroll in one of Jose Antonio’s high protein diet studies (~4.4 g/kg lol).

I’m pro-LC and HP but not anti-LF. Humans have thrived on a wide variety of diets over time regardless of macronutrient composition. Food quality seems more important in this context.

3. If ketones are muscle-sparing, then…

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