New Gundry Book - The Plant Paradox

[Russ]

Apologies if already mentioned elsewhere, but looks like Dr Gundry's long-promised new book, entitled "The Plant Paradox," will be finally be released next month.

https://smile.amazon.com/Plant-Paradox- ... nt+paradox

Most interesting is the fact that both Dr's Wahl and Bredesen have provided jacket endorsements.

Russ

[Stavia]

Guess they met at AHS16 thanks to us....

[Russ]

Sorry for not being here much lately. Popping in, I'm surprised to not see much explicit discussion of Gundry's new book, so having finished yesterday, wanted to throw one topic up for discussion that doesn't appear to have had much discussion here - Neu5Gc.

First, I need to get off my chest that the book was periodically intolerable to me. I got a lot out of my own consult w Gundry 3 yrs ago, and think he has much to offer. But the tone of overconfidence (even arrogance) was at time difficult to read past, and will become relevant to this thread. He started off on a bad foot when he explicitly accused Dr's Davis (Wheat Belly) and Perlmutter (Grain Brain) with focussing on the gluten in wheat at the expense of other problematic compounds. From this I can discern that he criticized both having never read the book - Dr Davis very early on (see p 38) went into how the term "gluten" was a term to hold the multitude of compounds largely separated into classes of gliadins and glutenins. I can set aside uninformed peer criticism as something that can be forgiven, but regrettably factors into how seriously I take other assertions in the book.

So I get to the new hub of his anti-meat argument which is now shifted from mTOR and and IGF-1 (at least in my consult) to Neu5Gc. But this section from p 156-159 contains not a single cited reference to anchor the assertion that Neu5Gc is a sound reason to reduce meat consumption. Having recalled hearing about a single new paper on Neu5Gc a few years ago, I set off to do some googling, and found this excellent 2-part series by Paul Jaminet...

Part 1 - http://perfecthealthdiet.com/2015/01/ne ... ease-part/
Part 2 - http://perfecthealthdiet.com/2015/02/ne ... hyroidism/

It was so refreshing to read something that was scientifically robust and objective. Now not that it's the totality of the subject, but Jaminet concludes that if you have Hashimoto's, shifting animal protein consumption from beef and pork to chicken and fish (similar to Gundry) might be a good idea.

Continuing on, the foundational paper in the space (cited by Jaminet) appears to be this one which focusses on cancer...

https://www.ncbi.nlm.nih.gov/pubmed/255 ... stractPlus

Abstract
A well known, epidemiologically reproducible risk factor for human carcinomas is the long-term consumption of "red meat" of mammalian origin. Although multiple theories have attempted to explain this human-specific association, none have been conclusively proven. We used an improved method to survey common foods for free and glycosidically bound forms of the nonhuman sialic acid N-glycolylneuraminic acid (Neu5Gc), showing that it is highly and selectively enriched in red meat. The bound form of Neu5Gc is bioavailable, undergoing metabolic incorporation into human tissues, despite being a foreign antigen. Interactions of this antigen with circulating anti-Neu5Gc antibodies could potentially incite inflammation. Indeed, when human-like Neu5Gc-deficient mice were fed bioavailable Neu5Gc and challenged with anti-Neu5Gc antibodies, they developed evidence of systemic inflammation. Such mice are already prone to develop occasional tumors of the liver, an organ that can incorporate dietary Neu5Gc. Neu5Gc-deficient mice immunized against Neu5Gc and fed bioavailable Neu5Gc developed a much higher incidence of hepatocellular carcinomas, with evidence of Neu5Gc accumulation. Taken together, our data provide an unusual mechanistic explanation for the epidemiological association between red meat consumption and carcinoma risk. This mechanism might also contribute to other chronic inflammatory processes epidemiologically associated with red meat consumption.

Together with Jaminet's excellent articles, I think the information could be a reasonable hypothesis, but hardly a well understood and proven as open-and-shut case as Dr Gundry presents (unreferenced). There are 23 subsequent references that cite this paper, most on cancer, one interesting one on broad autoimmunity, but not clear from titles and abstracts that any would provide a solid basis for Gundry's assertion.

To make matters worse, much later in the book (p 238), he asserts that 2 recent studies put the "final nail in the animal protein coffin." Luckily this time it's cited from 2 sources:

https://bmcnutr.biomedcentral.com/artic ... 016-0063-9

https://www.ncbi.nlm.nih.gov/pubmed/20592131

So imagine my disappointment (but not surprise) in finding that the 1st is an epidemiological analysis of country-level WHO data about meat availability and BMI in different countries - at best useful for hypothesis generation. The 2nd is an actual study which concluded that the equivalent of an extra steak per day would lead to an increase of weight of 2 kg (4.4. lbs) after 5 yrs. Note that neither has anything to do with Neu5Gc, but calling these 2 studies as "final nails in the coffin" just causes me to further question the merit of his claims re Neu5Gc as possibly just strong confirmation bias.

Now I have my own biases, too, but like most of you here, I really try hard to follow the trail of scientific data.

So putting aside other big questions for the moment (e.g. is the issue lectins or improperly prepared lectins?), since Gundry's treatment was central but very light, I would like to know if anyone else has dug in to this Neu5Gc and red meat thing yet?

To me, looks like an interesting and relevant hypothesis, but not even remotely close to firm and proven, so just another variable to consider in a complex array of interactions with pros and cons of different dietary choices and patterns (which even Gundry includes fasting as a countervening intervention).

[Tincup]

Russ,

On Neu5Gc, I don't eat animals that have that anyway, so I just thought "that's possibly interesting."

I've never read "Wheat Belly," but I will credit Dr. Davis with getting me to check my ApoE4 status from a comment he made in Jimmy Moore's "Cholesterol Clarity."

I searched "Grain Brain" for the word agglutinin and it came up with no hits. Gundry's point is that wheat germ agglutinin is more of an issue than some of the other wheat constituents. Especially with respect to insulin receptors, where it can block them. This is not something I had been aware of previously.

Overall, I tend to look at things and wonder, "what will happen to me if I do X." Gundry suggested his Phase 1, which is a kind of a fasting mimicking diet, for 3 days. Then eating very low saturated fat, including from olive oil for two weeks to not have LPS "hitch a ride" on chylomicrons across the gut barrier. He suggests perilla oil first and macadamia nut or avocado as seconds during this time. Having been looking at Valter Longo's work and patents on fasting/refeeding cycles (at least 6-7) and autophagy then stem cell activation, I decided on a 120 hour (5 day) water fast followed by eating ten Gundry compliant meals over ten days (I always fast 22 hours/day as a matter of course), then repeat at least 7 times. I'm starting day 1 of my second fasting cycle. On the refeeding, I followed Gundry's instruction and used only perilla and macadamia nut oil. 60% of my days were vegan. On the 40% that were not, I ate 2 egg meals, one white fish and one shell fish. What I've noticed since very early on in the 10 day refeed is that my chronic (since infancy) nasal congestion is the best it has ever been in my life. Prior to starting Gundry's program several years ago, I was starting to get RA-like symptoms in my hands. When I started, those symptoms went away nearly instantaneously. My congestion after starting was much better as well, but nothing like today and during this refeeding period.

[Russ]

George,

Just in case there's any doubt, here's a Dr Davis blog post from 2012 discussing WGA....

http://www.wheatbellyblog.com/2012/09/m ... s-delight/

Neu5Gc may be just interesting, but in this book, Gundry's now made it fundamental yet provided no visible support. I can imagine he actually understands the subject very well from his work in heart valve replacement immunity systems, and if so, just a shame he didn't illuminate more. I remain an open-minded skeptic by nature, so happy to entertain hypotheses if someone shows me some evidence. But my skepticism goes way up if someone claims things where I can research and discover exaggeration.

Very interesting fasting experiment. I remain intrigued in the deeper fasting protocols several here have done, and one of these days soon maybe I'll do a more rigorous fasting experiment myself.

[Julie G]

Great post, Russ. I haven't read the book yet, but it's on my to-do list. I was previously unfamiliar with Neu5Gc, but your links provide an excellent introduction. The quote below is a decent summary of Jaminet's advice for those with Hashi's (and other auto-immune conditions, T1D, etc?) Intristic, but not stated, would be avoiding gluten for the upregulation of zonulin (Fasano) known to disrupt the gut barrier in the first place. Those folks who are avoiding both gluten (and other grains) along with Neu5Gc (beef, lamb, pork) would end up with a diet pretty similar to what Gundry is recommending. It's fascinating to see multiple sources come to similar conclusions using various biomarkers. Additionally, Fasano discusses the role of various genes in rendering some more susceptible to zonulin upregulation making a strong case for bio-individuality with regards to diet. There are likely many folks who can tolerate grains and red meat and others for whom these cautions apply.

If this is the case, then the strategy for overcoming Hashi’s would involve:

-Improving gut barrier integrity and mucosal immunity,
-Normalizing or diversifying the gut flora, and
-Reducing dietary Neu5Gc by replacing beef, dairy, lamb, and pork with seafood and bird meats.

FWIW, we've spoken extensively about Dr. Gundry's hypotheses here born out by his clinical work with patients. If avoiding lectins results in reduced TNF-alpha, that speaks volumes to me. That said, I think we all want more definitive research proving his assertions.

[TheresaB]

I’ve had many things going on, so I’m only a couple chapters into Dr Gundry’s book, “The Plant Paradox” therefore I am not in a position to discuss Neu5Gc, but regarding Dr Gundry, Russ you wrote,

He started off on a bad foot when he explicitly accused Dr's Davis (Wheat Belly) and Perlmutter (Grain Brain) with focussing on the gluten in wheat at the expense of other problematic compounds.

GeorgeN addressed that with

I searched "Grain Brain" for the word agglutinin and it came up with no hits. Gundry's point is that wheat germ agglutinin is more of an issue than some of the other wheat constituents. Especially with respect to insulin receptors, where it can block them. This is not something I had been aware of previously.

I want to elaborate on this for a second because I think this could be a very important point which we need to be very much aware of as E4s. First, FYI wheat germ agglutinin (WGA) is not associated with gluten, it is found in bran (whole grains). In "The Plant Paradox" Dr Gundry cites 11 points as to why WGA is bad, but there was something he said about WGA during the ApoE4 dinner Q&A session at AHS16 last year that I keyed into, yet he did not discuss this in his book, at least not that I found using a quick search on my kindle version. He said,

Wheat germ agglutinin binds to insulin receptors on muscles and insulin receptors in the brain and blocks them. Muscles can’t get to the glucose. So when it binds to insulin receptors in the muscles you have sarcopenia and when it happens in the brain it blocks the effect of insulin. So a lot of what we think is Type 3 Diabetes is actually the accumulation through the years of wheat germ agglutinin.

And for those who may not have heard this before, Type 3 diabetes is another name for Alzheimer's, given the common characteristic of the AD brain's impaired glucose uptake capability. So if Dr Gundry is right, I think this is something of acute importance to E4s.

Okay, you all can go back to discussing Neu5Gc, I might join back in when I get to that point of the book.

[Russ]

Theresa,

I agree - an important point about WGA binding to insulin receptors highly relevant to us E4's.

BTW, this specific fact also pointed out by Dr Davis...

http://www.wheatbellyblog.com/2017/01/n ... not-fault/

"When WGA encounters a fat cell, it acts just as if it were insulin, inhibiting the activation of fat release and blocking weight loss while making the body more reliant on sugar sources for energy."

People just need to think when they here "gluten" as street language for "a bunch of nasty sh*t in most grains." Davis made sure to explicitly define it as such in his original book:

"The term 'gluten' comprises two primary families of proteins, the gliadins and glutenins. The gliadins, the protein group that most vigorously triggers the immune response in celiac disease, has three basic subtypes: alpha/beta-gliadins, gamma-gliadins, and omega-gliadins. Like amylopectin, gluten's are large repeating structures, or polymers, of more basic structures. The strength of dough is due to the large polymeric glutenins, a genetically programmed characteristic purposefully selected by plant breeders."

...and then shortly thereafter went on to say more about the nasty villains in wheat.

And here's Perlmutter in 2013...

http://www.thedailybeast.com/articles/2 ... dictionary

"While gluten makes up the lion’s share of protein in wheat, research reveals that modern wheat is capable of producing more than 23,000 different proteins, any one of which could trigger a potentially damaging inflammatory response. One protein in particular is wheat germ agglutinin (WGA). WGA is classified as a lectin—a term for a protein produced by an organism to protect itself from predation.

All grains produce lectins, which selectively bind to unique proteins on the surfaces of bacteria, fungi, and insects. These proteins are found throughout the animal kingdom. One protein in particular for which WGA has an extremely high affinity is N-Acetylglucosamine. N-Acetylglucosamine richly adorns the casing of insects and plays an important role in the structure of the cellular walls of bacteria. More importantly, it is a key structural component in humans in a variety of tissues, including tendons, joint surfaces, cartilage, the lining of the entire digestive tract, and even the lining of the hundreds of miles of blood vessels found within each of us.

It is precisely the ability of WGA to bind to proteins lining the gut that raises concern amongst medical researchers. When WGA binds to these proteins, it may leave these cells less well protected against the harmful effects of the gut contents.

WGA may also have direct toxic effects on the heart, endocrine, and immune systems, and even the brain. In fact, so readily does WGA make its way into the brain that scientists are actually testing it as a possible means of delivering medicines in an attempt to treat Alzheimer’s disease."

I have no affinity for one expert over another - many have much to offer. But it only impairs my confidence in an author when they feel the need to start by criticizing another author when they clearly didn't read the very thing they are criticizing. What else didn't they read before jumping to conclusions?

Russ

[Stavia]

I read Gundry's first book a few years ago. He was very confident then of his hypotheses, and IMO his references did not support his conclusions.
Here I see Russ assessing the evidence for Gundry's new hypotheses and finding it inadequate in his opinion.

For me there are two main points
1. When has an expert reached "the ultimate truth" rather than just another hypothesis? Gundry's opinion has changed a lot since his first book. Why is this now the truth when he was so confident the last book was?
2. Julie and George feel healthier and have reduced inflammatory biomarkers with certain interventions. I definitely feel unwell with wheat. And Russ, sorry, I know its your passion, but I don't feel optimally well with daily red meat (and its all grassfed here). Dairy makes no difference to me however.
I believe we should all test and tweak. Watch our own biomarkers. Learn from our own responses.

Sent from my SM-G930F using Tapatalk

[Russ]

I believe we should all test and tweak. Watch our own biomarkers. Learn from our own responses.

Quite agree. Seems like the strong agreement in this community is that individualization is key. But I think the trick is that even in watching biomarkers there is quite some complexity - e.g. your own frequent point about over-obsession with lipids (especially in US).

From Jaminet's post, I do think the blood test for Neu5Gc antibodies could be an interesting biomarker to look in to that could help us individualize our solutions, but we need to start with humble understanding what we actually know and don't know. It's just so tempting to assume we know what we think we do and that's how we end up with overly simplistic (if not flat out wrong) concepts like "LDL cholesterol levels = cause of all bad." I think if people had put their thinking caps on and done real science (instead of jumping to conclusions), such concepts would have never made it into the popular understanding, and we wouldn't be fighting them off still today.