‘Pie hole’, colloquial for one’s mouth, is believed to have evolved in the USA in the 1980s from the British expression ‘cake hole’ (coined in the mid 20th century). Pie hole refers to a mouth, as in: Shut your pie hole or, in this case: Put less in your pie hole.

Wednesday, April 12, 2017

This Article About Metabolism Will Put You to Sleep

Remember your body clock? The one that tries to keep you in tune with your basic needs like sleep? Well, your clock is actually much more complex than that. Did you know it plays a role in your metabolism and metabolic health? Interested? Duh, of course you are (and if you're not, you're probably browsing the wrong part of the internet.)

Let's not rest on our laurels and get right stuck into it. Spoiler alert: Cutting your eating interval (period of time during the day where food/beverages are consumed) can improve sleep and translate to weight loss.

Here are 5+ things you need to know:

1.  Your body clock is more like body clocks. New research finds "peripheral" clocks in internal organs are involved in glucose metabolism. These organs are tucked away where the sun don't shine, so it's not like they can rely on light/dark stimuli from the environment. Instead, they use the timing of food and fasting for regulation. Changes in the time food is eaten, or poor sleep can throw off metabolism. Did I mention these clocks are responsible for the expression of thousands of genes that regulate the 24 hour circadian cycle? Remember this for later.

2.  Circadian gene expression impacts metabolic health and thus diseases like type 2 diabetes and obesity.

3.  Circadian gene expression also impacts the microbiome. This research shows the biome composition and activity are dynamic and demonstrate a diurnal (daily) pattern. The composition of the microbiome is known to play a role in disease pathogenesis, appetite control, feeding behaviour, and brain function and behaviour.

4.  Several mouse studies have demonstrated:
  • Mice with mutations in their "clock" gene become obese on their regular diet. They also:
    • Develop signs of metabolic syndrome (high cholesterol, high blood glucose, lack of insulin)
    • Sleep ~2 hours less than non-mutated mice
    • Have disturbed eating patters (regular mice eat during their active period at night, mutated mice ate both during the day and night) - the equivalent of a human waking up and raiding the fridge overnight
    • Had exacerbated weight gain when fed a high-fat diet
  • Mice fed a high fat diet during the day (when they usually sleep) gained more weight than mice fed the same diet but at night during their normal active period (which is 12 hours)
    • The research discovered that the central clock remained tuned to the 24 hour cycle, but the peripheral clocks in organs were out of sync (caused by eating at odd times and lack of sleep)
    • This lack of sync lead to deranged metabolism, weight gain, and glucose intolerance (the start of a series of unfortunate events where type 2 diabetes is concerned)
Shake a leg, Sleeping Beauty... Here's where it gets (even more) interesting.

5.  Keeping your eating interval to 10-12 hours can lead to weight loss, improved sleep, and improved energy levels.
A small pilot study took adults (with a BMI>25.0) whose eating interval exceeded 14 hours and had them limit their eating (including all non-water beverages) to a 10-12 hour period. The 16 week pilot intervention did not include suggestions of nutritional quality/quantity/calories. Results showed:
  • An average weight loss of 3.3kg (7.3lbs)
  • Participants reported significantly improved sleep satisfaction, hunger at bedtime, and energy levels
  • Participants voluntarily continued the restricted eating interval unsupervised. At 36 weeks (1 year after the beginning of the intervention) participants had maintained their weight loss, improved sleep, and energy levels
  • The shorter eating interval translated to an average calorie reduction of 20%
A few other fun facts:
  • Sleep in healthy people is disrupted by light pollution (from lights and devices) that emit the same wavelength as the sun
  • Lack of sleep impacts glucose metabolism in healthy people (including children)
  • This lack of sleep can decrease resting metabolism enough to cause weight gain of 12.5lbs in a year
  • You can reset your insulin responsiveness and depressed metabolic rate after 9 days of recovery sleep
The all-important take home messages, I'm going to keep it super short: You don't have to change everything in your life to become healthier. If you're committed to making 2 changes, do these:
  1. Think about your usual eating interval, if it's more than 12 hours, reduce it to 12 hours
  2. Add more vegetables to your diet, whether it's including veggies with your snacks, lunch, dinner, breakfast, or all of the above (I like the latter option). Prepare a stool sample and call me in the morning!

Wednesday, March 15, 2017

Going Gluten-Free: The Unintended Consequences

Folks, if you are gluten-free, going gluten-free, or have a friend who's gluten-free... This one's for you. The gluten-free diet bandwagon that is so on-point and "healthy" right now is sort of just a crumbly mess (get it? coz gluten makes things chewy, so no gluten makes things, yeah you get it)... And, there's research to prove it.

First off, if you've actually been correctly diagnosed with Celiac Disease, that's a different story. In your case, a gluten-free diet for life is the diet prescription for you. If, however, you haven't been diagnosed (by a real doctor who followed the correct gluten-loading protocol before doing a small intestinal biopsy) pay attention and chew on this.

You gluten-free fans "think it's healthier", so you might be strained to read this... But just for you, I'll put the evidence where my Pie Hole is.

New research shows people eating less gluten have a higher risk of type 2 diabetes... Wait what? Go with me here:
  • People who follow a gluten-free diet eat less cereal fibers (you know, like whole grains)
    • Fiber is protective against type 2 diabetes... And many diseases like colon cancer, heart disease, diverticulitis, metabolic syndrome, obesity, constipation, and more
    • Gluten-free foods tend to have less fiber and fewer micronutrients (they are actually less nutritious, or less "healthy", seriously read the labels of gluten-free vs conventional foods)
  • People in the highest 20% of gluten consumption (about 12g/day) had a 13% lower chance of developing type 2 diabetes compared to those in the lowest 20% (about 4g/day)
  • This was a 30 year follow up study with nearly 200,000 Americans
    • The study began in 1984 and ended in 2013 - this is a caveat because it was prior to the gluten-free diet craze, the research doesn't have a group of people on a diet of 0 grams of gluten per day
But wait, there's more for you to noodle on (sorry, am I being gluten intolerant..?)
I dug around after reading the above new research and found a few other studies that had some intriguing findings:
  • After 1 month of following a gluten-free diet, participants had a decrease in healthy gut bacteria including Bifidobacterium, B. longum, and Lactobacillus
    • These are important for things like pooping, and colon cell turnover (helps prevent colon cancer)
  • The decrease in healthy gut bacteria was accompanied by an increase in unhealthy gut bacteria (E. coli and total Enterobacteriaceae), which was in parallel to the decrease in polysaccharide (fiber) consumption
    • From 117g to 63g (also important for pooping, wow, I got to drop another "poop" in this article)
  • In addition, immunostimulatory properties in feces (determined in large part by bacteria present in the gut) was remarkably decreased after following the gluten-free diet
    • Specifically, changes in inflammatory/anti-inflammatory compounds in peripheral blood mononuclear cells. These blood monocytes are known to constantly replenish monocytes in the intestinal mucosa (cells lining the intestine)
Translation = A gluten-free diet not only decreased the healthy gut bacteria populations, it increased the unhealthy bacteria, which is likely tied to the decreased fiber intake seen on the gluten-free diet. These together also decreased the stimulation of the host's immune system.
So, not only do gluten-free foods not taste as yummy as gluten-containing foods, they are also less nutritious, contain less fiber (insert poop emoji here), and they are damaging to your precious microbiome... Still wanting to go gluten-free? I guess you are a glutton for punishment.

You can read more about gluten intolerance here and here. More about the microbiome here and here.
Relax... They're funny

Wednesday, February 15, 2017

A2 Milk Protein for a Happy, Healthy Gut

Milk is frequently demonised on Facebook, by dieters, and by supposed "advocates" of "eating clean" (whatever that means)... So if you've never herd (get it?) of A2 milk, or don't know what it is, let's have a candid conversation about the controversies of cow juice, aka milk.

First thing to note is not all milk is equal when it comes to your tummy (and by tummy, I mean gastrointestinal tract).

Let's be clear, the posts and quotes disparaging milk are seldom backed by any real science. The food doctors of the world (us dietitians) continue to recommend the consumption of animal milk due to its richness in vitamins, minerals, and protein. We're scavengers, after all, so leech away life juice from your domesticated livestock!

What if I told you there's a certain protein in many conventional cow milks that cause your stomach trouble? Research (keep reading) explores symptoms like bloating, abdominal pain, diarrhea, watery stools that aren't quite diarrhea, increased gut transit time, and even cognition that are impacted by milk.

So here's the science in semi simple terms:
  • Most milks contain two protein variations: A1 and A2 beta casein
  • The A1 and A2 proteins vary only slightly in their amino acid makeup but have very different consequences following digestion
  • When digested, the A1 protein is broken down to produce "beta casomorphine 7" (BCM-7)
  • A2 is resistant to this breakdown and stays in tact (this is a good thing)
  • The beta caseins present in human, goat, sheep, and buffalo milk are classed as "A2-like" meaning they are not broken down into BCM-7 (this is a good thing)
Ok, that's the protein side of things. Now you need to know what BCM-7 is and does:
  • BCM-7 attaches to mu-opioid receptors
  • Mu-opioid receptors influence gut transit time
    • Let me interrupt myself for a sec, you know how opioid drugs like codeine can "stop you up"? BCM-7, similar to codeine, is a mu-opioid agonist which inhibits peristalsis, this results in slower transit time through the gut (this is not a good thing)
  • BCM-7 increases mucus secretion
Think of the two proteins (A1 and A2) as trucks, each with two trailers attached to them. As the A1 truck is getting on the freeway (being digested) the second trailer breaks off (remember, your GI tract breaks down the A1 protein). In this scenario, the breakaway trailer is now rouge on the freeway and will slow down oncoming traffic. The A2 truck stays in tact when it gets on the freeway (is not broken down during digestion) thus does not slow things down.

Righto, we've covered the groundwork. Let's get to the juicy stuff. How can your choice of cows milk cause your body chaos? Some recent research found:
  • Milks containing both the A1 and A2 proteins (mixed milks) caused worsening of GI symptoms (pain, bloating, diarrhea, watery stools)
  • Mixed milks were associated with significantly:
    • Increased colon transit time (the A1 trailer slowing things down)
    • Increased whole gut transit time (the A1 trailer slowing things down)
    • Increased concentrations of inflammation-related biomarkers
    • Decreased production of gut short chain fatty acids (these are favourable byproducts of bacterial fermentation in the gut, they have anti-inflammatory effects and enhance colon cell function)
    • Longer responses and increased error rates on subtle cognitive impairment tests (most likely related to increased inflammation-related markers associated with mixed milk consumption)
  • Subjects with diagnosed lactose intolerance:
    • Had significantly worse symptoms following consumption of mixed milks
    • Had no worsening of symptoms when consuming A2-only milk (about the same as when they consumed no dairy)
So let me interrupt myself again to translate these findings:

People often blame their stomach/GI symptoms from milk on lactose intolerance, however, this research suggests that such symptoms are not lactose intolerance, but a result of the A1 protein being digested into BCM-7, and BCM-7's flow-on effects which ultimately have negative impacts on gut functioning.

What can you do?

Start drinking a milk that is not a "mixed milk". You want a milk that only contains A2. The A2 Milk Company founded back in 2000 in New Zealand has a patent on a DNA test that ensures their dairy cows only produce the A2 protein. The test simply sequences a strand of tail hair. The A2 Milk Company now sells A2 milk in Australia, the UK, China, and the USA. You can read more on their website and find an outlet near you.

Disclosure: I received no compensation, sponsoring, financial incentive, or other inducements to write this article. I think the science here is fascinating and I see a potential group of milk-avoiders getting back on the milk bandwagon. I myself switched my family to A2 milk in June 2016 and have seen a huge change in our GI health as well as family and friends who have tried it. I own a small number of shares in the A2 Milk Company.