Rice for GERD?

My wife and I were faced with a bit of dilemma tonight regarding our 7 week old baby. She's been spitting up after feeding although it varies in severity but enough to concern us. My wife visited to the doctor today who suggested instead of giving her Zantac to try mixing a little infant rice mixture into the bottle of breast milk. This apparently can help her keep the milk down and reduce the symptoms of GERD. On one hand I liked the sound of this and was glad the doctor was avoiding just pumping her with medications but I also worried about feeding her young, still developing body with rice. My wife also wanted to research it a little so we avoided giving her any just yet and have both been reading about the implications of feeding an infant solid food like rice. It turns out there are some studies which indicate an increased risk of type 1 DM when babies are feed rice or cereal. The interesting point that came from one of the studies (the second one) is that there seems to be window (between 3 - 7 months of age) when the risk is lower of rice or cereal causing the development of type 1 DM. That seems amazingly odd, there is a window of a few months, miss it and you have a significantly higher risk of developing type 1 DM. However, a couple of other points fell out of this:

1) In the first study the babies all had at least one parent with type 1 DM and were identified as carrying a gene that predisposes someone to type 1 DM. The second study showed an increased risk regardless of the genetic predisposition but it was highest if the infant first has the food at > 7 months and carries the gene.

2) If the babies were fed breast feeding while given the rice or cereal their risk was reduced. I'm not sure if their total risk was reduced or just reduced compared to the other babies in the studies, meaning they still had an increased risk.

My wife and I decided we would hold off for the moment. The bubs symptoms do seem to be improving on their own so we're going to monitor her for the time being.

Regardless these studies made me wonder why are we trying to hard to feed rice and cereal to babies. Shouldn't the fact that feeding them those foodstuffs results in an increased risk of type 1 DM especially given that there is this small window when the risk is lowest suggest that maybe they shouldn't be eating them at all? Especially since the second study showed an increased risk even if the baby wasn't predisposed, at least that was my interpretation.


I grabbed these links from Kellymom, great site btw.

Norris JM, Barriga K, Klingensmith G, Hoffman M, Eisenbarth GS, Erlich HA, Rewers M. Timing of initial cereal exposure in infancy and risk of islet autoimmunity. JAMA. 2003 Oct 1; 290(13): 1713-20.

Ziegler AG, Schmid S, Huber D, Hummel M, Bonifacio E. Early infant feeding and risk of developing type 1 diabetes-associated autoantibodies. JAMA. 2003 Oct 1; 290(13): 1721-8.

Interpretation of the studies:

http://www.docguide.com/early-infant-feeding-and-risk-developing-type-1-diabetes-associated-autoantibodies

Primal Soda Replacement

In continuing my quest to rid myself of a nasty diet soda habit I experimented with creating another drink this time from soda water and green tea. The results were excellent, it's really refreshing, satisfies that need for something fizzy and also provides some health benefits (the Green Tea) and something sweet. Pretty simple really:

- Brew some green tea and stir in your required amount of Stevia
- Pour over a large cup of ice until the glass is about 3/4 full
- Add part of a can of La Croix Lime (or another other flavor your like) sparkling water

Don't add too much of the La Croix as it will overpower the delicate green tea flavor. Stir and enjoy.

Primal Thai Iced Tea - Alpha Release

I'm searching for some interesting options to replace my diet soda habit (Pepsi Max how I love thee) and one that occurred to me was Thai Iced Tea. I love that stuff, the familiar light tea taste mixed with intense sweetness combined with creamy coconut milk or cream all poured over a big cup of ice to make it really refreshing. Of course, I always felt guilty having one in the past all that sugar plus the saturated fat in the coconut or cream. I'm not worried about the saturated fat anymore but how can I make the rest of it more Primal and also compatible with Leptin Reset Protocol (LRP - sounds all technical and official)?

Dr K talks about Green Tea all the time and says he drinks it by the gallon and I keep hearing everywhere about the wonders of Green Tea. Here is a relatively recent meta-analysis of 18 studies, 5 of which were on green tea the rest on black tea. It did find a correlation between a reduction in Heart Disease and green tea consumption even at 1 cup per day. As always we must be careful to draw any conclusions from these results as the researchers point out more studies are needed as we don't know what other factors may have altered the results. Green tea drinkers might be more likely to eat vegetables for example or walk barefoot, who knows? What we want to see is a description and proof of the mechanism that results in the health improvement. Despite all that, we don't seem to see negative results from green tea consumption and there are a large number of studies (just search Google scholar) around the beneficial impact of green tea and there are some suggested mechanisms. Perhaps someone who knows more about biochemistry can explain some of the potential mechanisms but the evidence is enough for me to drink it and feel pretty good about it although I'm not expecting it to fix all my problems and walk the dog at the same time.

http://www.ajcn.org/content/93/3/506.short

Green Tea also appeals to me because it has some caffeine but lots of other health benefits but doesn't come with artificial sweeteners. So Green Tea will be the base, next up is the sweetener, artificial sweeteners are out, again the health trend at the moment seems to be Stevia which is an all natural product. My wife and I were at Whole Foods last night and as I stood in the Stevia section I realized I had no clue which was the best option I just knew to avoid Truvia since it has some additives. I ended up picking up Stevia in the Raw for no other reason than it was on sale and seemed to be pretty, well, raw. Since then I've realized I probably should have picked up a liquid Stevia, but you live and learn. Last but not least we need our creamy blob of fat to tie it all together. In this attempt I tried some heavy whipping cream because I had some open but next time I will try coconut milk.

The end result? Pretty damn good. I could drink this stuff, plus I can drink it guilt free. Saying that, I don't think I'd drink a lot of it, maybe once a day or every other day. I'm going to experiment with another concoction made on La Croix water and green tea for my more regular drink.

Here's the recipe:

• Mug of green tea, freshly brewed
• Big cup of ice
• 3 packets of Stevia in the Raw (or whatever Stevia variation you like)
• Quarter of a cup of heavy whipping cream

Stir the Stevia into the still hot tea until it dissolves then pour it over the ice. Gently pour the cream over the top sit back and enjoy.

Stay tuned for the next revision where I'll try coconut milk instead and perhaps a different brand of green tea.

Why did I get fat so young?

For a long time I've been curious about why I have always seemed to struggle with weight. My mother swears she fed me just like her other kids and that many of my friends ate more than me and a worse diet than me (worse meaning more sweets, cakes etc.). It shaped my whole childhood and much of my adulthood so as I've been on this journey over the last 8 months it's become increasingly important for me to understand why I struggled the way I did and still do.

There are a couple of theories I've bumped into the latest of which was actually elucidated by Dr Kruse, of Leptin Reset fame when I posted the question on his blog and again on the Leptin Reset thread on Mark's Daily Apple (MDA). I don't have any papers to refer to for this first hypothesis but you can find a long list of cites on Dr K's blog entry at the bottom. The second one can be found in many mainstream publications like WebMD and I have included some links to the abstracts of some studies (Google Scholar is my friend).

1. Our epigenetic switches are set by the initial burst of Leptin provided by our mother via Colostrum. So when a baby is formula fed this initial set point may not be optimal. Here is a quote from Dr K's blog regarding that point (http://jackkruse.com/central-leptin-dominance-for-health-part-1/):
   
   "Leptin is made from our fat cells but we are not born with leptin from our own fat. We initially get leptin from our mother’s colostrum from breast feeding. This initial bolus of leptin then immediately goes to our hypothalamus to “set” the leptin receptors and our epigenetic switches, neurologic wiring controlling appetite and feeding, neurotransmitters and peptides that all control energy balance. I view this like placing a USB drive into your new laptop with a new driver in it to tell the computer how to use the new hardware you want install"
   
   Here is a response to a comment from Dr Kruse on his blog (http://jackkruse.com/central-leptin-dominance-part-2/)
   
   "@Claudia you are correct. If the child is not breast fed and does not get leptin then the foods fed to the child will determine how their switches are set for the first six years of their existence. This has huge implications because the child’s gut also is playing a role here. It’s gut micro biome is determined by how it enters the world. We are designed to enter the world via the vagina. That passage gives us the inoculum of bacteria to start the gut micro biome and microfilms off to a good start. If the child comes via a c section the gut will be compromised. The child’s food furthernwill determine what kind of biome develops. If that includes infant formula loaded with HFCs and soy and gluten……well your life is not off to a good start. I think for women who realize these issues are big they can plan with ahead with stored human colostrum and post natal probiotics and a diet that emulates mothers milk which is very high in MCT and LCT fats and protein. Women who are leptin resistant or have IR (pcos) will be the moms most at risk for these issues and the risks are larger if them pregnant mom wasmlarge for gestational age and worse if grand mom had gestational diabetes. These all are bad epigenetic signs that foretell how the fetus will part ion it’s calories as it ages"
   
2. Removal of Tonsils results in higher obesity rates - This one has been studied at least in an observational study looking for correlations and they indeed found them. In fact, children who had their tonsils removed seem to show a fairly significantly increased chance of become obese. I'm not a fan of this kind of study or I should say I am not a fan of drawing any conclusions from this study. That would be skipping a few steps of the scientific method, however, it does give us an interesting place to look. The last couple of links reference the papers themselves, the full text is behind a pay wall, but you can read the abstract.
   
   http://children.webmd.com/news/20110201/tonsil-removal-may-lead-weight-gain
   
   http://oto.sagepub.com/content/144/2/154.short
   
   http://oto.sagepub.com/content/144/6/855.abstract
   
   As I said, these studies prove nothing, they show a correlation but the researchers couldn't possibly eliminate all the confounding variables so take them with a grain of salt.
   
   I have found a few ideas to explain this phenomenon although I don't seem to be able to find the links right now. I don't find any of them very satisfactory, but the first one does have some appeal:
   
   a) Hyperactivity
   
   When the tonsils are enlarged a child will suffer from a form of sleep apnea resulting in fatigue which leads to hyperactivity. Apparently fatigue and hyperactivity are commonly linked in children and this is not controversial, seems odd, but okay. With the removal of the tonsils and the improvement in sleep the child becomes less hyperactive which results in less fidgeting which leads to less energy expenditure meaning the same calorie intake will cause weight gain.
   
   This make some sense. Dr Lustig (of You Tube Sugar fame) talks about how in his practice when he sees a fidgeting child he knows they are not at a high risk of obesity.
   
   There are also various studies linking the removal of Tonsils to an improvement in ADHD in children.
   
   b) Mothers are Stupid
   
   After removal of the tonsils the mother over feeds the child resulting in obesity. Give me a break. Seriously. This is just idiotic. Mothers, driven by maternal instincts will deliberately cause their child to become obese by overfeeding them over a long period of time because they went into hospital for a short, very minor operation. Really? Who spouts this garbage? This smacks of the typical "everyone else is stupid" theory that are pushed by second-rate doctors and researchers. It's more like these mothers with their sharpened maternal instincts will do the opposite, they will worry about the food they are feeding their child not wanting them to experience the lifetime of pain that is associated with being overweight. I get mad every time I see something like this.

Honestly, I'm not saying I believe this is 100% the answer, but it's very interesting nonetheless and gratifying to see some potential pieces of the puzzle falling into place.

Leptin - Finally, a Hack that Seems to Work!

I've been at this a while. Okay, not as long as some people but I put a good 6 months in Paleo last year although I wasn't terribly serious but this year I've been at it for 8 months or so and I've been pretty damn serious. Yet my average weight loss is fairy unimpressive. Each of my experiments with different approaches to dieting has been about finding what works for me and also, ideally a hack that speeds things up a bit. I'll settle for just an extra few pounds every now and then. I'm not talking shop vac in the rectum on full power fat extraction, but just an occasional blip to provide a little extra kick of motivation. Is that too much to ask? Well up until recently I would have said, "yep, sorry dude, you've been a fat bastard for decades so don't expect it to change overnight". About six weeks ago after deciding that leangains style IF wasn't working for me I discovered Leptin and Dr Kruse's (Dr K) blog (see my regular reading widget).

When I first started looking I decided that I was already eating Primal which is what Dr K recommends so following his additional recommendations wouldn't be a big deal. For the first few weeks it was difficult because my daughter was born and honestly a somewhat stale, still cold from the fridge turkey sub is like crack after being up all night. So lectins and antinutrients be damned I'm downing that bread-narcotic and triglycerides and denser LDL particles can just go on forming that day. Then 3.5 weeks ago I started to get serious about it. Wow, it's an interesting experience. Since starting on it I'm losing an average of 3 lb a week. I NEVER. EVER. lose that fast. I've only got three weeks of proof so far, but hey, I'll take it, 9 lb in three weeks, sign me up! Will it continue this week? I hope so, but even if it doesn't, I'm still 9 lb closer to my goal.

So how does it work?

1. Eat a BIG breakfast within 30 minutes of waking. You can bend the 30 minute rule, but the BAB (Big Arse Breakfast) is required.
2. Breakfast should consist of 50-75g of protein and very little carbs. Don’t worry about fat and calories.
3. Do not snack, ever.
4. Leave at least 5 hours between meals
5. Eat lunch if you feel hungry, also make it low carb.
6. Keep carbs below roughly 50g per day
7. Eat a normal dinner, keep carbs low of course, to stay under 50g a day
8. Over time, try to phase out lunch and eat two meals a day. Eat more protein in the morning if you find yourself getting hungry before dinner.
9. Don’t worry about exercise initially


The goal is to do this for six weeks. I'm not counting the first 5 because I had a cheat meal every weekend. I started the six week clock last week so I'm 1.5 weeks into the 6 week reset.

The premise of this approach is that it resets your Leptin Sensitivity. Leptin is the master control hormone, the more body fat you have the higher your Leptin levels. Leptin is supposed to suppress appetite but when the levels are chronically elevated (yes, that would be me) we become Leptin Resistant. This effectively means the communication between the trillion cells in the body and the brain is no longer functioning appropriately. This has a whole heap of biochemical implications one of which is appetite control but others are insulin related and fat storage related. So it’s a vicious cycle the more fat you have the higher Leptin levels the more fat you will accumulate and store. This approach to eating helps reestablish Leptin Sensitivity, it can take a little while to settle in and 6 weeks are not always enough to achieve the reset but it’s a start.

From what I can gather, the big protein breakfast is really meant to help control cravings and suppress appetite. It does both for me. I can go all day without even thinking about food now. In the interest of full disclosure I do find I am eating less calories. Is the weight loss a result of the increase in Leptin Sensitivity or the reduction in calories. Not sure, although I'm not eating that much less than I did before. I am also not snacking at all. I have noticed other changes that Dr K refers to such as sweating more and increased libido.

So is a Leptin Reset the answer for me? So far it's working well, if I improve Leptin sensitivity it should help me continue to lose weight and keep it off.

Unhealthy Obession?

A discussion with my wife tonight reminded me of something I posted a few months ago after my sister visited and mentioned that she was worried about my obsession with weight loss. I appreciate both my wife and my sister's concern and I understand where they are coming from, however, I think differently on that topic...

Obsession. I want to break it down in this post and try to analyze my obsession and try to figure out if it's healthy and necessary or a sure path to the looney bin.

Whenever I write the word I hear it in my head as a sort of obsessssssion... in a sort of exotic, almost secretive tone, I picture a dark background with a woman looking provocative and an expensive looking bottle with clean lines. Something dredged up from my subconscious no doubt, guess the marketing worked. So perfume aside, am I obsessed? Maybe. Probably. I like it though, it keeps me focused. Maybe I should just let go. People are telling me this all the time these days, the people in the primal forum (over at Mark's Daily Apple) have all said it, don't track, don't obsess, just "live". It sounds so grand, I think, YEAH! I want to live! I want to go running through the park and do sprints on the beach regularly. I want to practice my grok squat and obtain the flexibility to sit in the position out bodies are naturally suited to. I want to eat amazingly healthy food and revel in the amazing health benefits and the abundant energy that results. I just want to do it ALL NOW!!! If only I was 170 lb or so, then yeah, forget tracking I'd just focus on eating healthy things and be done with it. Oh, to not be obsessed. To not google the nutritional content of the menu of the restaurant my wife and I are going to for dinner and pick out my meal before I've even left to drive there. Oh the luxurious freedom! To not take my measurements regularly. I mean seriously, I really don't want to own a body fat tester and a myo-tape, a heart rate monitor, those ketostix ketone testing strips in my bathroom cabinet are just sad. I've even considered testing blood glucose to see what impact different food have on me. Am I NUTS?!?!?! I would give it all up in a day to run free through the modern equivalent of the woods around my cave, replete in loin cloth and actually not having people averting their eyes, rushing the frail and sick away to safety and hearing the word liposuction muttered more than once. Sadly, I would never wear a loin cloth, and running through the park would be accompanied by me groaning about a sore knee, stopping every minute or so (okay, I'll make it a HIIT workout!). In other words, Grok wouldn't even recognize me. I'm not ready to be carefree Grok just yet. I wish.

Here's how I see it. When you have a good amount of weight to lose, it's going to take a while. Sure, you hear stories of people losing 60 lbs in 2 days drinking tears of a Tibetan Yak but for most of us, it's just going to take a really long time. Seriously long. So lets look at that, I need to lose weight, consistently for probably a couple of years. If someone knows how to do it faster and can guarantee it will work for me, please tell me. So honestly, let me ask you, what else can it be but an obsession? You have to stay focused for a really long time, eating the "right" things, doing the right things. Human being just suck at doing this, in fact, if a guy pursued the same girl unsuccessfully for 2 years you would say he was pretty obsessed. Maybe at the end of the 2 years she finally agrees to go on a date (have to have a happy ending). He was still obsessed. So seriously, what else could two years of sticking to a diet be other than an obsession. I can't see how it can be anything else.

What I did notice is the people who tell me to not be so obsessed are usually not overweight, or at least not very overweight. Those that agree, that tracking intake etc is important at first are those who have generally lost large amounts. They know from experience that you need lots of tools to stay focused, you need to be a little bit obsessed.

So it is a question of degrees, of course there is TOO obsessed. Of course, moderation in everything, everything in moderation. I think a little bit of obsession is necessary for many people, myself included to stay focused.

I know that carefree, grok in a loin cloth, life is waiting for me. Okay, maybe I'll always need to be a bit mindful, but if I hit 170 lb I can probably afford to stop tracking everything like a data obsessed junkie. No more nutrition.pdf all over my laptop for different restaurants, I can hang up my body fat tester, pee on all the ketostixs at once, giggle and throw them away. I can put a comment in MFD every day, "not a fat b@stard anymore, don't need you - Thanks for all the help but I'm free now". Until then I'll cling to my obsession because it helps me reach my goal. I know I'm mentally healthy because I have a cheat meal on Saturday nights and I love my giant hamburger or slices of delicious pizza, I take weeks off from official weigh-in every now and then to just chill out and enjoy a social event the night before. I think these are all signs that my obsession is not an unhealthy one.

Can we call it a moderate obsession? A healthy obsession? With the occasional dip into slightly unhealthy territory every now and then perhaps. When Grok would recognize me as a potential tribe member I'll put down my body fat analyzer, but until then I need to know where I'm going and where I've been.

N=1 equals Me

My first post will be an introduction and then hopefully I'll move onto much more interesting topics. I've been blogging on another members-only site for some time about my efforts to lose weight, improve my health and generally look better naked. :) I really started to become serious about the effort in mid-January of 2011 when I started to track my calorie intake and exercise. Since then I have read seemingly endless blogs, papers, articles and books on diet and nutrition and found that my understanding of those topics has been radically altered. For most of my life I have believed and followed the conventional wisdom relating to nutrition believing that I was well informed. Boy, was I wrong.

I've struggled with weight my entire life although I did lose it all on several occasions. The most recent was about 12 years ago when I reached my goal weight by following a low fat, high carbohydrate diet. I mostly maintained the weight for 2 years but then it gradually came back and I ended up around 270 lb. Last year in 2010 I followed the Paleo diet after being introduced to it by a friend who told me about Loren Cordain's book with the imaginative title, "The Paleo Diet". I found this idea really compelling so I followed the diet for some time and lost 28 lb. Not a bad effort, but I wasn't incredibly serious about it. The premise of the Paleo Diet is to eat essentially what we would have consumed prior to agriculture. Dr Cordain prescribes lean meat and plenty of vegetables, lots of omega 3 fatty acids and very little carbohydrates.

In January 2011 after 6 months or so of Paleo I decided I would aggressively track my food intake and start performing n=1 experiments on myself with different approaches to nutrition to see what worked in my case. So for the first four weeks I ate a low fat, high carb (lots of whole grains) prescribed by most of the medical profession. I lost 3 lb over 4 weeks. Not bad. Meanwhile I was reading Gary Taubes "Why We Get Fat and What to do about it" and became interested in low carb diets. So I decided to try eating low carb again for a month and compare it to the previous month. I also was introduce to The Primal Blueprint by some people on the food tracking site I use so I decided to do the Primal Blueprint form of low carb which is essentially Paleo with more Saturated Fat. That month I lost 4 pounds. Not a dramatic loss, about the same really, based on that I decided I could probably lose on any diet provided I calorie restrict. Despite that I continued with the Primal diet because my research indicated this was a healthier way to eat.

I've been eating Primal since then and although the weight is coming off very slowly I enjoy this way of eating and continue to believe it's the best option for overall health. I've lost a total of 53 lb although I put some weight back on last Christmas, so weight loss since January 2011 is roughly 35 lb. I'm not setting any speed records.

I also started to exercise more which has always been a problem for me. In the past I seemed to be able to diet OR exercise but not both simultaneously. This year I've managed to consistently exercise and diet. I've been lifting weights 3 times a week for many months now and prior to that did weights and cardio or jogging. This has resulted in not only weight loss but a 10% drop in body fat percentage.

A couple of months ago I decided it was time to shake thing up a bit and look for another hack to speed the process up. So for three weeks I tried the Leangains protocol which is predominately used by body builders but it's a form of Intermittent Fasting (IF) which has grown in popularity and is supported by some studies showing positive metabolic changes and weight loss. Sadly, three weeks on leangains resulted in zero change in weight or body fat %. After some more research I found that many recommend IF for those already at a low body fat % which doesn't help me at all. I did receive some feedback that I should investigate Leptin and read the blog of a Neurosurgeon, Dr Jack Kruse. I read his blog and although initially I found it almost impenetrable, I was able to extract some useful information and satisfy myself that it at least made sense. After a little delay I finally became serious about following Dr Kruse's advice about 3.5 weeks ago. Since then I've been losing an average of 3 lb a week.

I will go into more detail regarding my adventures in different approaches to losing weight in other posts but that's the summary of my journey thus far. My goals have evolved over time, initially I just wanted to lose weight and reach a number on the scale but now I am interested in optimizing myself. In achieving my maximum genetic potential, whatever that may be. I not only want to be a healthy weight but also to have a healthy body fat composition, good blood lipids and be fit and strong. So I'm focusing less on the number as a goal and more on how I feel. I am aiming to reach a normal body fat % and I track my weight but I don't obsess quite as much about the final number.

So this blog is all about my journey to n=1 optimization. Perhaps one or two people will find it useful.

-D