Friday, August 21, 2009

Taste

One of, if not the, key aspect of food for most people is taste. The sensation of a good taste is a prized experience, something which we devote a substantial part of our attention when it comes to food. For some meals, it might be the only consideration. To define my terms here, when I refer to “taste”, I am referring to the physical sensation you experience when holding food in your mouth as well as the larger sensation of wellbeing that you experience when eating what your body wants you to eat at that moment.

My completely unsupported theory is that when it comes to food, there are three fundamental factors in play. In order of survival priority:

1) Calories. You need to have enough energy to survive.

2) Nutrients. You need to attain enough vitamins and minerals to maintain your body.

3) Poison. Don’t eat something that will kill you obviously, but also avoid things that are merely detrimental without being instantly fatal.

Taste is one tool that has evolved in order to assist us in handling these three fundamental food factors. It rewards us for eating something when we are hungry and attain calories. It gives us hints as to what we should eat to attain the necessary nutrients. It warns us when we put something in our mouths that will cause harm.

Ideally, taste would serve only to help us accomplish healthy living, but this is an ultimate goal. Proximately, we are driven only to eat what tastes good, and taste is something that easily loses its calibration. Therein lies the problem.

Taste can be trained by experience, as evidenced by the phrase, “an acquired taste”. We train ourselves to like the way something tastes over time, which overrides taste’s natural function. Rather than serve as a tool to assist our survival, it becomes corrupted by the socialization process and begins to drive us to eat things we have trained ourselves to want to eat. When this happens, we find ourselves with a very powerful physiological and even emotional attachment to the foods we have been trained to eat over time.

This process begins when we are children. We are weaned from milk and begin eating solid food, very likely some sort of baby formula. These formulas are inevitably carbohydrate based, and while they provide adequate nutrition for survival, they do not provide optimal nutrition for health. One can see evidence of this in every child that requires braces, every child that requires glasses, every child that suffers from any chronic illness not caused by some environmental factor. We did not evolve to have poor eyesight, bad teeth, narrow noses and allergies, and when you examine populations eating their traditional, primitive diets, you discover that these ailments occur at vanishingly small frequencies in chidlren. (1)

But railing about childhood nutrition isn’t the point of this post. The purpose of illustrating the failure of early nutrition is to point out that this must inevitably train our sensation of taste to accept a certain class of foods. Our taste is thus trained to fail at its second most important function – indicating nutrient rich foods – almost from birth. It’s important to point out that adequate calories are almost always provided by these diets. Our taste is being successfully trained in its primary goal – to drive us to seek food which provides energy. It simply is not being taught how to recognize the second, and arguably failing to detect the third.

It’s also important to recognize that we likely have an evolutionary urge to eat carbohydrate rich foods such as fruits. Fruits, being mostly seasonal and far less sugary in evolutionary times than at present, would likely never have served as a staple food in our diet. However, they would be available seasonally, and would be a rich source of energy. We would gorge on fruit for a time, which would likely coincide with the end of a time of bounty. We’d fatten up due to the insulin spike and fructose, and thereby be prepared with adequate fat for the lean season that would follow. By feeding that urge early, we train ourselves to give in to it constantly, well beyond the ability of our bodies to handle the carbohydrate intake.

This is reinforced as we grow older through various social conventions. Celebrations inevitably involve food, and the most prized food for any child weaned on sugar-rich formula is almost always sugar-rich. We crave birthday cake, cookies, ice cream, candy – our taste, trained to seek out sugar, drives us blindly towards foods which fail utterly to provide even a semblance of nutrition. As we go through our lives, foods will come and go as the object of our obsession, but our bodies never forget the lesson they learned early on – seek calories and seek sugar.

That taste is addictive should not really be disputed by anyone. If you believe that food is not addictive, I challenge you to quit cold turkey. More seriously, if you believe that sugar is not addicting, I challenge you to quit cold turkey. If you believe that your way of eating is not addicting, I challenge you to change it radically overnight. You will find it both physiologically and emotionally difficult, having been trained over a lifetime to seek a certain spread of foods.

This brings me to the social aspect of taste. It is common to hear loud exclamations of satisfaction when one sits down to a large dinner. This is, after all, polite. You are complimenting the cook and the family on their excellent food, and sharing in the experience of that excellent food with people you are close to.

What remains unexamined is the way this social experience drives us to value foods. We are seeking taste sensations that we perceive as valuable because those around us are indicating that they are valuable. An American would find drinking the arterial blood of cattle revolting, perhaps even physically upsetting, whereas a Masai herdsman and his friends would pat their bellies and exclaim their satisfaction (or whatever the equivalent Masai way of showing contentment is). The blood is actually very nutritious, as it turns out, but we are incapable of appreciating that without proper training. As we sit around the table telling each other we are eating something good, we are participating in a social taste training ritual which tells us that what we are eating is good. What is lost here is that eating is not, fundamentally, about socializing. It’s about acquiring adequate calories and the optimal nutrient balance for health.

The modern American has completely lost that sense of food. We assume that we will get adequate calories and adequate nutrition, and so feel comfortable completely ignoring these aspects of food in favor of the social aspects or simply feeding our poorly calibrated taste buds. The results are not pretty. We get fat. We get sick. We get chronic illnesses. We have no energy so we eat five times a day in order to keep the sugar rush going until we finally overload our body's ability to handle insulin and get diabetes. By the end of our lives our intestines are scarred to the point where we often need supplementation just to get adequate nutrients. But we ignore all this, failing to make the connection, either willfully or because when everyone is doing something, it’s very difficult to think that there’s anything wrong with it, and thus we just don’t think about it.

Oh, sure, we count calories for a few months or read a headline about fat being bad and buy lean chicken breasts, or have a glass of red wine with dinner for the anti-oxidants. The truly dedicated exercise religiously and follow some health guru or another towards their random idea of optimal health. But we rarely give up that early training. We almost never escape the socialization of taste. In the end, we remain slaves to a sensation that is not providing us good guidance.

One of the most common things people ask me is how I don’t get tired of meat. It’s quite simple: meat is able to supply my caloric needs, is nutritionally complete, and is not a poison. Your body will not ever tire of something that is meeting its needs, once your taste sensation is re-calibrated to adequately sense those things. After only a month of eating an all meat diet, I can honestly say that I sit down to each meal with my mouth watering at the thought of what I’m about to eat. I can’t wait to eat another steak.

A further question I receive is something along the lines of, “well, why deprive yourself of things that taste good?” This question has two answers. The first is contained within the introduction post to this blog. The second is better served with a short illustration:

Imagine that you are walking through the park one day with your two-year old, when a man walks up to you. The following conversation takes place:

Man: So, have you given your kid heroin yet?

You: My god, no! Why would I do that?

Man: Because it’s such a great trip! Why would you deprive your kid of that?

Clearly, giving children heroin is a bad idea. It’s addictive and physically destructive, and a habit that you really don’t want to form in your two-year old. This more or less outlines my reasoning on food experiences. I know that chocolate double fudge cake is a good trip. A very good trip. But it’s also an addictive, physically destructive trip that fails utterly to provide me with any substantial nutrition.

I recognize that this is not a view shared by many, and is not the way people want to live their lives. It is, however, the way I’ve come to view food. The social aspect of food is dead to me, and I’m weaning myself away from my trained cravings as time goes by. Taste follows nutrition, rather than obstructing it – I’m training myself to enjoy the taste of that which is healthy. For me, good food is that which provides calories, nutrients and isn’t a poison. A blood rare unseasoned ribeye steak does all of these things – and damn does it taste good!

Phil

1 – Nutrition and Physical Degeneration, Weston Price, the entire book

Monday, August 17, 2009

Books to read

Good Calories, Bad Calories - Gary Taubes.

(Diet Delusion in the UK)

Taubes has made his career writing about bad science for newspapers and the journal Science. He discovered his next target in the late 90s: public health. After spending years reviewing journals, studies and the history of public health, Taubes essentially concluded that the standard wisdom rested on a very faulty foundation, and that the slate needs to be wiped clean so that real science can be done. This book is fairly long and dense, but very engaging if you are interested in the science he is discussing.

The Fat of the Land - Vilhjalmur Stefansson

Stefansson spent years in the arctic eating an all-meat diet. On his return, he subjected himself to a supervised medical experiment in which he ate nothing but meat for a full year. He wrote several books about his experiences. He draws on those books in The Fat of the Land, in which he argues that healthiest diet is one that is predominately based on animal meat. This book contains Stefansson’s take on the experiment he engaged in, as well as an overview of the use of meat in arctic exploration.

Nutrition and Physical Degeneration – Weston Price

Weston Price was a dentist who, in the 1930s, decided to take a survey of the primitive people’s of the world to see what their teeth looked like. He quickly discovered that so long as a population was eating its traditional diet, their teeth were nearly flawless and had very low incidence of tooth decay. Moreover, he found that they were typically in good health and did not appear to suffer from diseases of civilization. Price took pictures of the teeth and facial structure of the people he surveyed and those pictures are fairly remarkable to view. Price’s prose is a product of his time, so one must be careful to sift through the claims about “racial stock” and “racial purity” to reach Price’s ultimate conclusion: that nutrition, not race or racial purity, was the cause of society’s physical degeneration.

Life without Bread – Wulfgang Lutz

Basically, this is a low-carb diet plan that focuses on total health instead of weight. Lutz spent decades treating Crohn’s patients with his diet, with a claimed 80% success rate. He published his book in 1967 in German, but it was not translated to English until the early 2000s. It was eclipsed by the Atkins diet, and is critical of Atkins in the sections about implementing a low-carb diet.

Introduction and explanation

The purpose of this blog is to serve as a way for me to explain what the heck it is I'm doing to myself for the next year. The number of shocked, confused or otherwise disturbed looks I've received over the past month have convinced me that it's time to put something like this together. It's obviously difficult to answer all questions someone might have in a single conversation without forgetting an important detail or mangling the delivery, so I hope that this site will serve to do a better job than I do in person!

For this blog to work, you have to do one thing for me. You have to assume that I’m not a moron, that I’m not deluded, and that I have put and am putting fairly significant effort into validating the safety and validity of this experiment. Please grant me the courtesy of an open mind and a fair hearing – if I’m wrong, I’d love to hear how and why, so long as the rebuttal is formed logically and on sound evidence.

With that out of the way, I'll start at the beginning.

I was diagnosed with Crohn's Disease in 2003 at age 19. I was in ROTC at the time and weighed in at 137 for my final PT test - and I'm 6'3". I was placed on prednisone and asacol, cortico-steroid and anti-inflammatory drugs respectively, and eventually gained weight up into the 155-165 range depending on what time of day I stepped on the scale.

For obvious reasons, this sparked an interest in diet and health. After about a year of very strict eating (according to a random plan which was based on a poorly researched jumble of knowledge), it became clear that the medication was doing its job with or without my dietary restrictions. Since I was able to live my life without thinking much about it, I gradually relaxed most of my restrictions. I still limited the dairy to hard cheese or yogurt, rarely drank (after my sophomore year in college, that is) and typically tried to eat what I believed, without much justification, to be healthy.

In 2007, I received the first indication that perhaps this strategy might not be ideal. A colonoscopy revealed a large inflammatory polyp in my intestine. Inflammatory polyps rarely develop into colon cancer and are associated with inflammatory bowel diseases, but there it was. The doctor took a biopsy and it came back negative for cancer. At the time, I shrugged it off and went on living.

In June of 2009, there was a discussion at the lunch table at work about diet and health. For some reason, I recalled something I had read about a medical study done on two men who ate nothing but meat for an entire year. There was suitable skepticism of that claim, and I couldn't remember important details, so I went back to my desk to see if what I remembered was true.

As it turns out, there actually was such an experiment. Vilhamur Stefansson and Karsten Anderson ate nothing but meat under the supervision of the Bellevue Medical hospital in New York for one full year (1). It's important to recognize that "meat" for them did not mean "lean chicken breast". Over the course of the experiment, both men averaged 60-80% of their daily calories from fat, the remainder from protein. What trace carbohydrate they received came only from the muscle glycogen of the meat they consumed or seasonings.

This experiment was preceded by a fair amount of controversy. The diet experts of the day proclaimed that both men would be stricken with scurvy within weeks or months and the experiment would have to be terminated in order to save them from certain death. When the year was completed and both men remained in good health, there was an even greater stir. The lead doctor in the study wrote that the most remarkable thing about the results was the totally unremarkable nature of the results - both men were hale, healthy and content.

I was somewhat startled to read all this. It took a few days of confirmatory googling before I was willing to believe that this was true, but when I discovered the text of the study on one of the medical journal publication sites, it was impossible to deny the veracity of the report. (See 1)

It was also impossible to square with what I believed to be "healthy". Fat is bad, right? Red meat causes cancer and rots in your guts, right? How didn't they get constipated without adequate fiber? They avoided deficiency diseases somehow, but how? The entire framework of what I believed to be healthy had been challenged, and it was a challenge I couldn't back away from.

I dove into Stefansson's background and discovered that he had spent about a decade, in aggregate, exploring the Arctic. As a Harvard anthropologist, he spent years living with and studying Alaskan Eskimo who had not yet been westernized. The families that Stefansson stayed with disdained plant life as unfit for consumption except in times of extreme need. They ate caribou, seal, whales and fish, often lightly boiling the meat over a tallow-fed flame to produce broth and stock (2). Most remarkably, Stefansson claimed that they had no incidence of any of the diseases of civilization, and wrote a book about his unsuccessful attempt to find a case of cancer amidst Eskimo populations living traditionally. (3)

THAT caught my attention.

Now, I can understand if one is skeptical of the claim that primitive populations had vanishingly small incidences of one the number one killers in modern society. I was for a while as well. However, the more I looked into it, the more independent sources I found claiming exactly that. Missionaries or pioneer doctors would go to an unsettled frontier and begin treating the native peoples. (4). So long as those natives were living according to their traditional lifestyle, eating their traditional diet, they rarely showed signs of any heart disease, cancer, metabolic disorder or tooth decay. As the frontier moved through and those cultures began to westernize, that rapidly changed. The change was so rapid that individual doctors who worked the same areas were able to record the shift over the course of a single generation.

Weston Price, a dentist in the 1930s, traveled around the world attempting to catalogue the health of primitive populations. He would compare populations of the same “racial stock”, or basically groups of people that were from the same geographical area or tribe, who were eating either a traditional diet or were eating a westernized diet. In all cases, those eating the traditional diet were in better health than those eating the westernized diet, and rarely showed any signs of the diseases of civilization. (5)

This isn't to say that pre-industrial societies were free of all ills. They still got infectious diseases, still broke bones, suffered through famine and drought and a generally harsh existence. They just didn't get cancer or have heart attacks. A standard response to this I get a lot is "oh they just died at twenty so they didn't have time to get heart disease." This is not supported by the data. The meme about cavemen only living to twenty is one of those things that one repeats without thinking or confirming it - and when you try to confirm it, you quickly realize that it's a mangling of reality. If you discount child mortality, most primitive cultures had life spans rivaling those of industrial societies. Their ages at death were close as well. (6)

As I discovered all this, I started to realize that it wasn't something I could just ignore. It was a fundamental challenge to the way I was living my life, made all the more relevant by the fact that I suffered from one of those previously non-existent diseases. I continued to read and research, but within the course of a week I was very well convinced that I needed to make a lifestyle change, if only as an experiment. So in late June, I began low-carbing.

Keto-adaption is not fun. The standard American diet is carbohydrate based - depending on what you eat on a given day, you might get upwards of 60% or more of your calories from carbohydrate. A low-carb diet is fat based. Adapting your metabolism from one to the other is not a trivial undertaking for your body. It takes a week or two before the initial period is over, more for some people, less for others. Full adaptation in trained cyclists took about 7 weeks in one study of a ketogenic diet, and that might only represent something like 90% adaptation (7). Full keto-adaption is probably an ongoing thing, much like adapting to whatever diet you happen to be eating. Worse, my Crohn's is active in the last section of my small intestine, which is where a fat and the byproducts of fat metabolism are absorbed by the body. A predominately fat based diet is not easy for my intestines to extract energy from.

At the time of this writing, I am about two months into this process. More like a month and a half. My energy levels are slowly returning. My digestive processes went through some turbulence but seem to have normalized into a pattern. I dropped about seven pounds - prior to the start of the experiment, I would weigh in at 160 or so when I woke up. Now I weigh in at 153 pretty consistently.

Sometime towards the end of July, I began reading about fiber. Fiber has become one of those things that everyone knows is good for you and which you have to have in your diet. Ask why and you will receive some logical sounding answers such as that it adds bulk to your stool, thereby facilitating elimination and preventing constipation. Sometimes people will cite studies claiming health benefits to fiber, or claim that by moving things along very quickly it prevents toxic waste from building up.

As far as I can tell from reviewing the literature, none of this is proven. There appears to be little benefit for most people in adding fiber to the diet. It has no effect on cancer rates (8). Simple and obvious questions reveal the logic behind its effects on constipation to be incorrect – ie, how is it possible that Inuit who ate vanishingly small amounts of fiber didn’t all die of constipation? No properly constructed study has shown any effect in preventing constipation (9), and indeed virtually every fiber supplement carries with it a warning that it might cause constipation!

Worse, fiber, being indigestible, always reaches the large intestine intact, where it is fermented by various bacteria. The resulting chemical action and bacterial overgrowth is speculated to play a role in Crohn’s, though the focus is usually on simple sugars. The theory is that the immune response starts by attacking a bacterial infection in the colon, but gets derailed and begins attacking all intestinal tissue.

As someone with an irritated gut lining, it seems totally counter-productive for me to eat a bowel irritant which fuels unnecessary bacterial overgrowth. Unfortunately, if one is going to eat a low-carb AND low-fiber diet, one is left with almost no dietary option except meat and animal products. It took me the month of July to really reach this conclusion, but at the end I realized that there was no point in doing this by half measures. So on July 20th, I ate my last vegetable (some spinach).

My plan for the next year is fairly simple. I will eat nothing but meat and animal products, and drink nothing but water. I will avoid all food additives including artificial sweeteners (topic for another post!). I will measure the results of this diet by keeping a food diary, logging the frequency and severity of my bowel movements (a standard metric for Crohn's), logging my weight, and soon logging my energy levels by starting and logging a workout routine.

My last colonoscopy was August 1, 2009. The doctor discovered another inflammatory polyp and noted the usual inflammation associated with Crohn's. A further test of the results of this diet will be to see what my colonoscopy next year shows. I'll probably get a physical as well.

Some people have asked what would cause me to stop this diet. Well, if my energy levels do not recover to the point where I can do the things I like to do, I would consider terminating the experiment in September. If my weight drops into the low 140s, I would stop as well. If I begin to notice anything really 'weird', I'll assume that I'm starting to have a vitamin deficiency and start taking a multi-vitamin. If that doesn't clear things up in a week or two, then I will stop the diet. At six months, I will do a “gut check” to see if I want to continue. For now I'm testing the result obtained by Stefansson and others that showed that no added supplementation was required.

It’s important to note other individuals who claim to have eaten nothing but meat for long periods without issue. Owsley Stanley, of LSD and Grateful Dead soundman fame, is a dedicated adherent of the all-meat diet. Since he’s managed to survive for decades, I’m confident I can last a year. Random googling has turned up a “zero carb” forum, which is a community of people who eat nothing but meat, usually to lose weight, various blogs of people who have turned “carnivorous”, and other contemporary examples of humans surviving for at least one year on a carnivorous diet (10) (11). We will see if I have the same result.

So that's the introduction to what I'm doing. If you're still with me, I appreciate you taking the time to read this and hopefully it covers the basics. I will be writing additional posts in the coming days focusing on some of the claims I've made above, as well as trying to address the questions that seem to come up the most frequently. Above all, I want to assure everyone that I have not gone insane, that I haven't developed an eating disorder or otherwise cracked. I'm not going to start preaching, either, although if at the end of this year I'm in better health than I was at the beginning I hope that you don't ignore the implications for yourself. I consider this my choice and I have no desire to push my choices on other people. Above all, this is an experiment. I have no idea what the outcome will be, but I have no doubt that it will be interesting!

Phil

1 - Prolonged meat diets with a study of kidney function and ketosis: http://www.jbc.org/cgi/reprint/87/3/651

2 – Not By Bread Alone, Stefansson, pg. 15 – 39

3 – Cancer: A Disease of Civilization? Vilhjalmur Stefansson

4 - Good Calories, Bad Calories, Gary Taubes, pg. 89, (whole chapter entitled Diseases of Civilization)

5 – Nutrition and Physical Degeneration, Weston A. Price, the whole book.

6 – Longevity Among Hunter-Gatherers: A Cross-Cultural Examination, Michael Gurven, Hillard Kaplan: http://www.anth.ucsb.edu/faculty/gurven/papers/GurvenKaplan2007pdr.pdf

7 - Ketogenic diets and physical performance, Stephen D Phinney:

http://www.nutritionandmetabolism.com/content/1/1/2

8 - Dietary fiber intake and risk of colorectal cancer: a pooled analysis of prospective cohort studies: http://www.ncbi.nlm.nih.gov/pubmed/16352792?dopt=Citation

9 - An Evidence-Based Approach to the Management of Chronic Constipation in North America, American College of Gastroenterology Chronic Constipation Task Force:

http://www.nature.com/ajg/journal/v100/n1s/full/ajg2005519a.html

10 - http://www.carnivorehealth.com/main/2009/6/13/things-ive-learned-after-a-year-on-the-all-carnivorous-diet.html


11 - http://zeroinginonhealth.com/