2016 Ancestral Health Meetup - Stavia's blog

[Stavia]

Nancy and Circ you are in our thoughts.

And oh my! I posted the first bit before Dr Wahls started talking. She was just fabulous. I can't wait for everyone to hear her views. She is highly intelligent with a keen analytical mind, pragmatic and at the same time intensely kind. Wow. What a combination.
I have so many ideas swirling about in my head as I am sure many of you do but what many of us got tonight was a strong feeling of hope and trust that our bodies will tell us if we are using the right strategies.

[Stavia]

Day three talks:

GEORGE DIGGS
More consequences of evolutionary mismatch, implications far beyond diet and excercise.

I missed the first 10 mins of this as I had the privilege of time alone with Dr Terry Wahls. Didn't hesitate for a heartbeat.

I entered the room as he wound up explaining the concept of supernormal stimulu, whereby many living creatures are primed to response to "larger than life" variations of normal objects or events in preference to appropriate signals. Little birdies will peck at big bright red thingies on power poles and hence die instead of being attracted to less red, smaller berries.

Humans have an innate drive to signal status such as health, sexual vigour and success and this results in us wanting more and more. This drives economic problems, destruction of natural habitats, pollution and extinction events. It is a trap.

Is climate change yet another evolutionary mismatch? An evolutionary trap? Despite the evidence there is widespread global inaction.

We may not be wired to deal with this becuase of cognitive biases.
1. we are evolved to respond to immediate threats...
2. ...sudden threats...
3. ....that don't require short term sacrifice. (loss aversion basis)
4. we have investment in group identity and will follow social signals
5. we are wired for xenophobia and climate change requires broad cooperation.

My comment: this certainly opened my eyes to the view that we should not lose sight of the big picture when considering evolutionary mismatch issues.

[Stavia]

IAN SPREADBURY
Refined foods and the gut microbiota - a toxic mix?

Ian is a delightful PhD in neuroscience who is now training as a doctor with a view to enter Family Medicine (yay).

His talk was extremely complex and the combination of his keen mind, great sense of humour and vast amount of detail in his slides rendered me unable to take notes. I gave up and just let myself thoroughly enjoy it.
Watch this talk! its excellent.
TLDR: processed foods, through effects on the gut microbiota, trigger complex inflammatory changes that drive obesity - independent of insulin resistance. It is the whole foods that is the key. Dense nutrient broth of highly processed foods overfeed bacteria resulting in a few species exploding in number and hence overwhelming the normal diversity.


Remember the massive weight loss with the rice diet? This would explain that paradox.
PS. exercise increases gut bacterial diversity


Addendum: went thru the slides on the plane:

IAN SPREADBURY
His hypothesis is that refined energy rich diet produce an upper GI microbiota than can trigger an inflammatory reaction causing Western diseases. Classic carbology blames insulin but worldwide there are carb based diets eg Kitavans Okinawans and ancestral diets do not seem to be dependent on micronutrient ratios to produce extremely low non-communicable disease rates. The common thread seems to be the absence of processed foods. It is well known that obesity or leaness can be transferred from mouse to mouse via faecal transplants.
If the microbiota is implicated in disease it will specifically be that of the small not the large bowel (colon) because of the small bowel-vagal conection thus Ian feels colonic faecal samples are of limited utility in investigation and management of these issues.

He discussed experimental evidence whereby pulverizing food negated the effects of different food sources ie mice all got equally as obese with different powdered food sources as opposed to the same foods in the whole state.

What about very low fat diets such as the famous Kempner rice diet study? Ian hypothesizes that the success is due to its "whole food-ness" not its micronutrient composition.

How does this all work? Immune cells in the wall of the gut react to bacterial signalling and then communicate to the brain via the vagus nerve. There are individual differences in response in this pro-inflammatory/ anti-inflammatory balance. Downstream effects include autoimmune, cardiovascular disorders, diabetes and obesity.

[Stavia]

MICHAEL RUSCIO
Do you really want a hunter gatherer microbiota - pearls and pitfalls.



The problem with extrapolating data from the Hadza for instance to us with regard to gut microbiota is that there is generally a pole to equator gradient with respect to the fibre:meat composition of diets. More carbs generally at the equator. There exists a biased sample of hunter gatherer microbiota skewed to the tribes that eat more fibre - but they actually make up a smaller percentage of actual hunter gatherer societies.

Dr Russo feels that it is better to empirically tailor diets in our population according to symptoms. He views microbiome testing purely as an academic tool at present as interpretation and interventions are currently unclear.

He went into detail various methods he uses for bowel disorders which I will not list here. Included in these strategies are fibre only to tolerance and FODMAP exclusion. He feels that it is ironic that the ones that are most likely to do the worst with high fibre are the ones that are enthusiastically advised by the blogosphere to feed the gut bugs with +++ fibre.

He shared his huge task in assessing the huge body of evidence for the "fibre prevents colon cancer" theory. The evidence does not support this. However whole foods diets reduce colon cancer.

[Stavia]

TERRY WAHLS
Feeding your microbiome for optimal health
......its all about your poop....seriously I'm not kidding.....


Dr Wahls introduced her topic by putting our evolutionary history into context. We have co-evolved with our microbes - both gut and their mitochondrial remnants. Our gut microbes are under selective pressure and influence our behavior through cravings, appetite and mood changes. We also have gut viruses.

She alluded to the "too clean" environment theory.

She discussed the role of gut bacteria in CNS disorders (such as prefrontal cortex myelin formation), RA and even mood status.

Consequences of reduced gut biodiversity is lowered resilience to perturbations. Our bacteria have a myriad of complex metabolic functions.

Many commercial probiotics cannot engraft and die. VSL3 (?) survives. Fermented foods. It can take months to years to develop a healthy gut biome. How do you know it's working?
She encourages us to use the Bristol stool chart and aim for #3 - smooth, bulky sausage-shaped 3x a day!

[Stavia]

DR CATE
Bad Diet Bad DNA - epigenetic and sequence mutations redefining the human race
.....post in progress....mainly about autism....

[Stavia]

At lunchtime yesterday Dr Bredesen asked us to recreate our lunch at the Buck Institute last year where we all briefly shared our stories. It was an emotional moment for some of us, though I note that not all of us felt this way. I guess due to individual circumstances some of us are less scared than others. In addition now that we have our site and have at least some broad suggestions as to positive changes new members can make, new members are less in the dark as previously was the case.

For many members this site has provided a soft landing as they discover their apoe4 status. It was completely different a few years ago for Julie, Gilgamesh, Susan, Ski. Things were still in flux when I found it 2 and a half years ago. Cindy who joined us a few months ago shared her experience of finding us - with strategies, my primer, our welcoming environment all ready.
This is very much our mission. We do this purely because it is needed and someone has to do it.

There is a lot of work going on behind the scenes and we may be calling out for help in the future. I personally will be forming a team of volunteers to be on a roster to welcome new members. This will free the mods for other duties. If you have any specific suggestions for the role of this team or if you feel you could play a part in it please PM me. The team is not yet fully formed and I am still considering, in consultation with the board, how it should be structured.

[SusanJ]

I'm going to throw in a few other observations from talks. In no particular priority order.

Aaron Blaisdell was brilliant. He presented some very simple steps to take on the hardest thing for many of us - changing our diet. One additional thing that he said really stuck with me: we can value a future reward to delay habitual behavior, but not if too far in the future. So, it means if I want to eat better, it's best to find a short term goal, say "I want to hike farther without fatigue", or "extend my morning fast" and make diet changes to meet those goals (that of course will take us to the long term goal of no AD.) We've all heard the advice to break a long-term goal into small actionable steps, but it's a good reminder if we're trying to break a bad dietary habit.

Gundry sets a target of 10-12 for the omega index. He thinks crab is effective at lowering sdLDL (okay, so I see a run on crab legs happening here) and uses grape seed extract to lower triglycerides because it improves cholesterol excretion. It also boosts hepatic NAD+ and SirT1. (My note, resveratrol, fisetin and quercetin are also SirT agonists.) And from Bredesen's talk, I think I understood that SirT1 is the dominant issue for E3s.

If you want to be scared about refined oils, flour and sugar, see Chris Knobbe's presentation about macular degeneration (AMD). It is a disease with similar behavior to AD, with excessive deposition of drusen leading to blindness. AMD was non-existent before the widespread adoption of refined foods, particularly refined oils.

In Ian Spreadbury's talk, another to watch, he argues for a vagal role in obesity and energy homeostasis, affected by changes in microbiota. Changes in upper GI bugs can cause inflammation, which causes changes in what the vagal nerve sends to the hypothalamus (which also shows changes). This is fundamentally different than old arguments that obesity is caused by not enough fiber/SCFA production in the colon, because the gut vagal nerves are situated on the upper part of the GI track. So, perhaps the "newer" refined foods like flour and sugar are merely creating an easy-to-digest, high energy environment for bugs, and would explain the changes in microbiota in obesity. If you like geeky stuff or want to understand new paradigms for obesity, watch this one.

[SusanJ]

Dr. Ruscio's talk (Do you really want a hunter/gatherer microbiota?) was a good warning for bloggers and functional medicine folks who want to treat all GI diseases the same: as in let them eat probiotics (including fermented foods), prebiotics and fiber. He says that some people will not do well if they have non-ideal GI immune regulation. I was especially heartened to hear this talk (given I fall in the IBS category). He reminds people that you shouldn't treat people as one size fits all - why would you want to, as a clinician, make their symptoms worse!?!? And he was very pointed about looking first for reviews of RCTs and RCTs to understand what works.

His advice:

1) Eat to reduce symptoms, reduce inflammation and control blood sugar, not to feed specific microbiota. Creating a healthy gut environment will foster growth of healthy bacteria.
2) Just because we have low diversity and are sick, it doesn't mean fiber and probiotics will fix it. It may make many worse.
3) He doesn't recommend microbiome testing - assays are academic, there are constant oscillations and no one really knows what a healthy microbiome is or how to treat the findings. Researchers also don't if certain patterns or diversity are cause or effect, and the tests miss a large part of the GI track.

He suggests to optimize microbiota by changing the environment:
1) Diet and lifestyle
2) Digestive enzymes, probiotics, vit D, maybe fiber if it can be tolerated
3) Microbiota reset: yes, sometimes giving antimicrobials or antibiotics, and perhaps using liquid diets
4) BUT, gradually increase dietary boundaries and wean off supports, and start including more carbs, more fermentable foods and FODMAPS
5) Last, potentially add in supplements like fiber, prebiotics, and resistant starch

In general, research shows that low FODMAP, low carb paleo work best for GI conditions like IBS, IBD.

If you struggle with gut issues, this would be one to spend some time on.

[SusanJ]

While probably everyone else was in Dr. Terry Wahls' talk, I took one for the team and went to the talk on histamine intolerance by Dr. Georgia Eades. She is not in the research field, this is more her distillation of what she has found as a sufferer of histamine intolerance. Not a lot of new information for me personally, but I want to throw some of the information out there. If you are new to the idea of histamine intolerance, you might want to check out this talk.

About 1% of people have it, and 80% are middle aged (Maintz, 2007). Research suggests it is acquired (through gut dysregulation) and not genetic (my own opinion is that you can be genetically predisposed, and affected more in the right circumstances).

Basically, histamine intolerance is sensitivity to food that’s not fresh, like cured foods (sausage, hams, etc), beef (it is one of the few products you can’t find fresh because it is typically hung for aging), and what she called the "fermentation fad". Looking at tested levels of histamines in foods, you see it can vary wildly depending on how the foods was processed and handled.

(Any of us who suffer from this know that sometimes you are rolling the dice every time you buy something at the store, because we have no clue of how the food was handled. Fish and shellfish are the most frightening things to buy if you can't trust your stores. I know from first hand experience.)

Histamine is in the class of biogenic amines, which are signaling molecules. They are transformed from amino acid (histidine -> histamine) and regulate cell growth, hormone release and neuronal activity.

Histamine sources in the body include: immune and blood cells, stomach cells, nerve cells. It effects, skin, respiratory uterus, FI, leukocytes, bone marrow, CNS, and cardiopulmonary.

Sources from outside: bacterial fermentation of proteins, intentional (fermented or cured foods) or unintentional. Scombroid poisoning is an example of unintentional, fish gone bad, that can sicken anyone histamine intolerance or not.

DAO is an enzyme that break down histamine coming into the gut and its deficiency in the gut is the most common problem. GI compromise (Crohns, Celiac, Chemo) is primary cause. Disease such as Celiac can open the tight junctions and allow histamine to escape the GI track into the blood. It is rare to have genetically low DAO. And B6, C, Copper and Zinc are co-factors needed to break down histamine.

Bacteria in gut can also cause additional histamine in protein degradation. DAO is highest in small intestine, but if protein escapes digestion, it heads into large intestine where there is less DAO to break down the excess histamine.

Examples of high histidine foods includes spinach, tomatoes and avocado. There are also histamine trigger foods but I think she noted that there is no good reference to the list of foods. (Seems to be true if you search around the web.)

But, it might not be just histamines causing problems. Other DAO inhibitors include putrescine and cadaverine (other biogenic amines), alcohol and certain medications. She says that any alcohol inhibits DAO, but also NSAIDS (see the talk for others).

And estrogen and histamine reinforce each other. This is certainly something I want to look at more closely as I try to raise my estrogen levels (and certainly don't want to raise my histamine levels.)

How do you know if you have it? First, rule out other food allergies. Testing is too hard, even using the histamine challenge. Skin prick test is best, but wait 50 minutes to read the results. It is about 80% reliable.

Her advice?

- Eat fresh foods (freeze leftovers immediately - it will slow the bacteria but not destroy existing histamine).
- Best to do low histamine diet and keep diary of food and effects.
- You can eat fish but "Frozen at sea" is best.
- And important to us chocolate lovers, organic dark chocolate is lower in histamine because of how it's processed.

And supplements, antihistamines/mast cell stabilizers, and DAO supplements can be helpful.