READERS SUMMARY:
1. What dietary context really means.
2. What is epigenetics?
3. How a thread can help thousands of people?
4. Sharing thoughts can really help us all out.
5. How did grandma and mom turn off or turn on your metabolism? And what have you done to it recently?
The Quilt took me years to lay out in my own mind based upon my experiences as a surgeon. Sometimes it is really neat when I get a bolt of lightening from a person that I am communicating with. That occurred this AM when I was giving some feedback to a fellow “netitizen” on a forum about his labs he posted. My inclination was not to really give my feedback because I tend to be a polarizing presence at this place. But based upon some of the responses in the thread and the “ambient awareness” I have with this particular poster over the net for the last 6 months, I decided it was prime blogging landscape.
Some background is needed. Mr. Kronk posted his VAP (lipid profile) on a website and asked for feedback. Since I have been interacting with this particular person for sometime I think I have a pretty good handle on him over the last 6 months. He is quite fit and he eats a “classic Paleolithic diet” by most standards. In the past year he has consumed 150-200 grams of carbohydrates per day by his own admission. His labs prior to this have always been acceptable to him. He has admitted freely that his carb intake has gone up over the last year with few ill effects. On many threads he, and many others like him, advocate a much higher carb intake than I would advocate “generally”. In fact, the feedback I was going to give him was precisely that. I knew if I did it would cause a shit storm on the forum with many others who think root tubers and fruit at this level are perfectly fine.
As a surgeon who sees many patients a year, I know this belief is valid for a much smaller subset of people that walk the streets of the USA. But that is when the light bulb went off for me. I am constantly harping on “context” with so many people about dietary micro’s and macro’s. I have seen many respected paleo bloggers talk about what is and is not paleo and what how paleo is lifestyle not a diet. Well, I look at Cordain, Wolf, and Sisson’s work as Paleo 1.0. I look at DeVany as paleo 1.5, and Kurt Harris latest manifesto as paleo 2.0. I like their ideas when they are put in proper cellular context. But the more clinical experience you have you can analyze things quickly like a doctor does in clinic; you quickly realize there is no uniformity in to how people respond to the advice of these gurus. Moreover, I think Jack Kronk’s VAP is going to help lots of people understand why that happens because I fully expect this will open a lot of discussion somewhere on the net.
Most reading this will likely agree with me that a paleolithic diet is how a human should eat. But where many of us will disagree is the breakdown of the carb and dairy content of the particular paleo diet. I think Paleo 3.0 for me is quite simple. It should be based upon the context of what your epigenetics was then and is now.
What does that mean, doc? It means go find out what kind of diet and body your grandmother had before she got pregnant with your mom and when she was pregnant with your mom. Then find out the same thing about your mom with respect to you. This will tell you more than you can imagine. When I was in med school we learned about Darwin and Watson and Crick whose dogmas both said we are what our genes are and how natural selection of evolution acts upon those genes. That is called genetic determinism. It has been dogma for a long time. It still is in most of the medical literature up until the last few years. We now know that our genes are not the most important thing to our life. It appears that epigenetic modifications to our DNA are what determines what genes are turned on and turned off. This is where grandma and mom come in. We inherit all our mitochondria from our mothers. Mitochondria are how we make energy from food to live. We also know that grandma has a bigger impact on the type of mitochondria and metabolism we inherit than it does from our mothers. Mom is still important in this, but the key is to know about both of them in determining what kind of metabolism you’re likely have today. Now think about how you have epigenetically altered your own DNA with the food choices you have made since you can remember. Where you a thin person most of your life or normal sized? Were you always heavy? How about your body composition throughout your life? Write them down. If you don’t know about grandma or mom go ask someone who does know. Write them down. And ponder what and how you eat now.
The variability we see in patients who eat a paleolithic diet are most likely due to epigenetic factors that I just mentioned. That is why people like JK have always believed that high carbs are not a problem for their entire life. Their experience made them believe that. The converse is also true for someone like me. I knew carbs had to be kept low because of what I knew about my own grandmother and mother and what I did to myself the ten years before I became a morbidly obese surgeon. In the last 5 years I have treated hundreds of people and seen just how variable their clinical response was to the guidelines in Paleo 1.0 books, in Paleo 1.5 and 2.0 advice. This advice however will help a large segment of the population eating a SAD, but it is too general for the N-1 that I work with daily. In the last three years, I “thin sliced” my observations and started to make recommendations based upon the epigenetic clues I get when I speak and observe my patients and my fellow posters. My observations have lead to my clinical treatment changes and evolution in thinking. The results have been nothing short of a miracle for the people who shared this information with me.
It is now the main reason that I believe deeply in a “quantified self” path of change as the Paleo 3.0 way to live. We need to eat in a fashion that gets our epigenetic programming back to optimal evolutionary environment our brain is designed to work best in. We know that our DNA off and on buttons are all controlled by methylation and acetylation of chaperone and histone proteins now. Take a guess where the methyl and acetyl groups come from biochemically. The answer is from our diet and the environment our food grows in. That environmental info is codified in the electrons our food is broken down into in our bodies and delivered to our mitochondria.
My belief is Mr. Kronk’s VAP shows what his recent diet choices have done to his current “on and off” switches in his liver. The current epigenetic modification of his DNA’s off and on buttons so to speak. He clearly does not like what he sees. Well, Jack…I have great news for you. Epigenetic science says you can alter the “on and off” genetic switches minute to minute and get your liver back to optimal if you make the changes that optimize you. Our genes don’t control us, but our thoughts do. Thoughts are epigenetic signals too, but too few think that way. What we do with our thoughts control gene expression. In a sense, in a mammal with an expanded neocortex thoughts are biologic endocrine secretions that change behavior by altering dopamine levels in our brain. That is what epigenetic is all about. This is a great opportunity to help thousands of people in my view. This may begin to get people to start thinking differently about how to make their own correct decisions about what type of paleo diet they need to be eating for them based upon the current status of their off and on switches. It gives complete context to what a paleolithic diet can and should do for a human. None of us are currently representative of Kitavans, Inuit, or Okinawans so comparing what they ate to us is useless because our epigenetic signals are far removed from theirs historically. When we get back to an optimal baseline then it matters big time.
Paleo 3.0 is all about eating in context of our “on and off” switches. These are monitored via our labs and clinical responses. This is how I do it in my clinic. The labs tell us precisely what food does to our switches. You can choose to discount it or you can listen to them. It is your choice. Most of you know I listen to labs all the time. Here is a chance to tear my QUILT apart……or add a giant piece to it. What say you JK?
CITE
Also see Chris Masterjohn’s June 30, 2011 blog at the Daily Lipid
you are suggesting personalized nutrition profile. I am not sure if that is possible with the current knowledge we have. One can try but the trial and error process seems to be time consuming and difficult.
its possible. I do it for my patients in my clinic. The real issue is you have to have a clinician who gets it and asks you the correct questions……then apply what they found to maximize your epigenetic switches to avoid disease. Its very possible. Its how we reverse diabetes. I dont believe in treating it. I believe in eradicating it.
Very interesting. But the big question is: how can I know which genes are turned on and off? What labtests do you use? What to look for?
Here they are Andrea. https://jackkruse.com/what-are-the-optimizing-labs…
I think you nailed it here as far as truth is concerned. The problem I see is that most people want a plan such as do A,B,C and your results are D. What you are stating (correctly, in my estimation) is that it depends on your DNA or more specifically how you optimize your rDNA. This will be much harder for the average person to understand and put into practice because it is not "cookie cutter" but more individualized. It is a distinction WITH a difference. Good luck. There are a lot of people out there who can benefit from this.
Don't kid yourself, change like this is going to take a lifetime. It's like trying to turn an aircraft carrier.
I find this very interesting. I would love to hear more about this. So would people of tomorrow whose parents and grandparents ate a high carb diet function better than those of us whose parents didn't? This might mean a reduction in obesity and diabetes in the next generation. Or have I misunderstood this? If you have any links where I can read further on this I would be very interested.
My parents, aunts and uncles and grandparents are all normal weight, but over half of the people of my generation are overweight and several are obese. This might help to explain why. The food available to this generation bears no relation to what their parents/grandparents had available to them.
Thanks again
Dr K – I think it was very thoughtful of you to write this post in response to Jack's post. Nice work.
I would respectfully ask you to tackle the issue that I think is really at the core of it, which is – what are your views of the Lipid Hypothesis and its variants. Everything thing like whether he should reduce his fructose consumption, vary macronutrient ratios, etc etc is secondary IMO. I really would welcome your thoughts on this.
Thanks,
Aravind
@ Aravind…….I think JK knows what I think. If he really wants me to hack him here I would do so only with his approval. He is a real good guy and I know this bothers him. But the answer for optimal dietary selection is based upon each one of our epigenetic profiles. To totally hack him we would need some more labs. Im really interested to see if he has a mild adrenal fatigue and pregnenolone steal syndrome with this VAP change. The best news for everyone Aravind is that epigenetics shows each one of us that we can alter our genetic determism. It has completely change genetic research and clinicians outlook if they actually understand the concepts we have found to be true. Many of the arguments we have had on PH about macro's and micro's are completely understandable when you have this concept firmly working in your brain. Many dont and I really dont want to get into a pissing contest with people who are dogmatic in how they think about their brand of paleo. This is also why I did not support KH brand of paleo. His version is quite simple and easy to follow but it may not be optimal for everyone of his readers. But I understand why he said what he did. It cuts to the chase for 68% of the bell curve. Since I see patients daily and he does not I have to use epigenetics to help them. I think JK can bury or prove that maybe this quilt idea I have has some legs with his N-1 results?
I don't quite understand if we are to eat or avoid eating what our grandmother/mother ate. For instance, I know my mother ate a lot of candy bars; she lived behind a gas station and had most of her teeth removed shortly after I was born.
From this: "I knew carbs had to be kept low because of what I knew about my own grandmother and mother and what I did to myself the ten years before I became a morbidly obese surgeon" are we supposed to assume you, your mother and grandmother ate too many carbs?
I am not overweight, but have lost 10 pounds since I cut back on carbs and went sugar-free.
Thanks Dr Kruse, This is a fantastic hypothesis – What the community needs next is a self examination checklist built by doctors like yourself. Paleo 1.0 and 2.0 came about largely due to self experimentation. In fact, Jack Kronk having done a VAP test for himself is a consequence of his knowledge and belief of Paleo 1.0..
looking forward to much more on this from you.
I wasn't asking you to hack Jack. I was asking you what YOU think about the Lipid Hypothesis and its variants? Thanks!
@ Aravind My thoughts on the lipid hypothesis are pretty clear I thought. I have written about it some on this blog. I reject it completely. I do not believe dietary fat or cholesterol has anything to do with heart disease. As for the variants, please be a bit more specific and I will answer you. I think if you read my thoughts on Framingham in my June 12, 2011 blog you'll see my beliefs about cholesterol.
I do think that macro's can hurt you badly. For example PUFA omega six and carbs are a death sentence in all humans. That is the SAD. I also think that SFA with extreme fructose consumption and omega six consumption are bad. But the reason has zero to do with SFA. Its the fructose and omega six together that nail you. These metabolites increase methylation and acetylation of our histones and chaperones and turn on our BAD switches in our livers. This is what I see in Jacks case. I wish his testing went further because his case is an awesome teaching case for our paleo community. I hope he considers this.
In Jack's case I am not too worried about him long term because his cardiac CRP was quite low at .33. That tells me even though his VAP stunk, it stunk in the face of a low inflammatory cellular homeostasis. (Levee One and most important) I think his VAP was representative of what his last 8 months of diet did to his Acetyl CoA levels and his methylation levels. I bet his homocysteine went up in that time frame and his B12 level fell below 450 as well. I also bet his Phase I and 2 detox pattern in his gut are off big time and his D level is low too……below 50 is my bet. I also think he has dysbiosis by testing and I bet his EEG is off too……decreased REM. A DEXA scan would likely show a change in body comp too. And I bet if we tested his hormone levels he'd get another kick in the shorts. This is all part of a "quantified self" program.
@JJ……it depends what the future people have to eat and what they chose to eat. My beliefs are things are going to get substantially worse for the world if they eat what america produces. We are a country who lives eats and sleeps on a diet of processed omega sixes, fructose, and grains. This turns on every bad transcriptional and translational process you have in your genes. If you do it long enough you get neolithic diseases. Some of us who had grandmothers and mothers with really bad diets will get these diseases sooner than later than past generations. I submit to you this is precisely why we are seeing early onset obesity in kids, early onset type two diabetes, and unreal amounts of depression and neurodegenerative diseases as well. Its all epigenetic and not our genes. People need this information from their docs because they can change it rather abruptly. We know this even today. In two weeks a paleo diet can completely reverse the epigenetic switches in type two diabetes. Dr Alessio Fasano at Maryland proved that in 2010.
Thanks for the response. Much appreciated!
@DentalQ I know its hard…….but my job as a doc is to tell the patients the good bad and ugly and help them decided what to do. Today patients are abdicating their power to doctors who have no earthly idea how to stop this. Healthcare has become a cookbook of evidenced based nonsense based upon opinion and not biochemistry and evolutionary biology. Until patients realize this no change will happen. So I have a duty to teach them these principles. It then becomes their duty to something about that.
@Andrea. That may come down the road in a blog. Right now I cant practice medicine on the blog but I can tell you there are tests out there we use to figure out how a diet turns on epigenetic switches. The key is having a clinician understand it and treat you. That is the part that is lacking today. The best advice I can give you is read about this quantified self testing idea…….the more data we have the better decisions we can make together to keep you away from my OR table.
"We also know that grandma has a bigger impact on the type of mitochondria and metabolism we inherit than it does from our mothers"
Dr. K, is this both grandmothers or strictly the maternal grandmother. Would her health status be important In addition to information about diet? For example, if your MGM died of cancer in her 30's would this also provide some epigenetic clues?
The book Nourishing Traditions zeroes in on these same concepts about maternal diet prior to pregnancy. How far in advance of conception do you think these dietary changes need to be made to flip the switches.
OK, I will collect all data that I can get (Endocrinologist, Rheumatologist, Gastroenterologist) and will figure out what the numbers tell me. What I know is that my enzyme production is disregulated – not enough Diaminoxidase (Histamine Intolerance). This means I am in "chronic low grade inflammation" even if I eat no junk and with not being obese. Scary!
Of course you can't practice medicine on the blog. But there are Paleo bloggers (MDs included) who give you general guidelines about what labtests to do for certain problems and what numbers to aim for. This is general information, not personal medical treatment. So I would appreciate it very much if you could write a post about this.
I just don't know WTF my genes are doing. I would visit you personally but the journey from Germany to Tennessee is a bit too expensive and I couldn't find a knowledgeable MD in my area. "Paleo Diet? Epigenetics? Functional Medicine? Huh? Wadda ya talking about?" Actually I tell docs what labtests they should do to get rid of their visceral fat or carb faces and what type of exercise they should do – if they are open minded. And here's the shocker: Most docs I met don't care for their own health – let alone optimal living! What can you expect from those people? "Well you know – it's all in your genes/the aging process/ (……)" Fill in the blank. I understand that they don't care for my health (they are not allowed to)- but not being interested in their own well being? Strange.
You can't practice health care if you are a slave of insurance companies and government regulations. Only sick care and evidence based nonsense. Rolleyes! You obey the rules of the Hippocratic Oath or you obey the rules of the medical-industrial complex. You can't do both. Period. That's how it works in Germany. Suppressing symptoms (drugs) or treating symptoms (surgery) but not treating the cause or helping patients to do their own research and homework.
Hi Jack, have been following your blog with great interest. As a science professional in a different field, I very much respect you making such structured and accessible communications here on your blog.
Regarding uniform paleo prescriptions, this brings to mind another popular approach – are you familiar with Martin Berkhans 'leangains' approach? (Leangains.com) The basics are: primarily common paleo foods (and avoidances), intermittant fasting (8pm-12pm), carb and calorie cycling (excess calorie days are high carb), 3 x week high-load low-volume weight-training. While no real data is available, negative testimony is sparse, and I now know of n~20 athletes of amateur calibre (with pro aspirations) who have greatly benefited from this approach.
In your understanding, do you know what the physiological angle this approach is utilising to shed fat but retain and/or increase muscle mass? Any speculations on whether there is a pending negative side? Or consequences to prolonged use?
Best regards,
John
PS. Should further mention, Martin doesn't sell anything (the promise of a book has lingered for years). He also enjoys sharing many many testimonies and before + after photos on his site – male + female and many who are not aspiring athletes or even under 20% bodyfat to begin with.
Is a very curious approach.
Correction on the book referenced above, it was Deep Nutrition by Catherine and Luke Shanahan, that focuses extensively on maternal nutrition, not Nourishing Traditions.
PPS. I should be more specific. The main concern is around the ~400+ grams of carbs, 3 x a week, one might commonly consume on 20% overfeed workout days. With, for e.g., ~170 gram protein and ~50 gram fat for a 70kg, 15% body-fat male. (macro sources mainly common paleo)
The other 4, non-workout, days would typically see ~50-90 grams carbs at ~20% calorie underfeed, higher protein, e.g., 190 gram (approach: ~3g per kg lean body mass), and 50 odd grams of fat, again.
A weekly deficit would be scheduled (i.e. 20-50% underfeed 4 x a week) if looking to lose weight.
I won't recite the science-based proposals for the approach (leptin is a central premise), is on the website and is interesting to read.
Dr k, professor de vany feels that the A1c is the most important. Do you agree? Any problems with this test? Finally, are you a member of professor de vany's blog? Thx
@Adriana You should start ASAP with regards to pregnancy. Leptin controls fecundity and oocyte development. Another little known leptin fact. It’s critical. the reason the maternal grandmother side matters most are these two reasons……we only inherit mitochondria from our mothers and two that the egg that became you was first formed when your mother was a fetus inside your grandmothers womb so you began your original epigenetic programming at that point. Men sex cells dont mature until puberty and women are born with all the eggs they will ever have as soon as the emerge from the birth canal. No matter where look at human biology leptin is there. That is why it is in levee two high up in the quilt.
@V…..its important for the quantified self program. It tells the patient that his switches are flip the wrong way……but it is a late indicator. HS-CRP is by far a better indicator because it is an acute phase protein from the most important organ of the body with regards to metabolism…….the liver. I think if you look back at my leptin series you will see how I use HS CRP clinically
@John……I am quite familiar with Martin 's work. I actually love what he recommends but here is my big issue. No one should IF until they become LS first! That is critical to the success of IFing. Once you are LS I fully advocate IFing to even a greater degree than even Martin goes to. The reason it works is because it sensitizes the liver circadian's clock to that of leptin centrally. In effect, it makes the liver an extreme furnace for fat burning. It optimizes all human UCP proteins. But it absolutely requires proper leptin function at all three levels…….brain, liver and muscle. It also works best when all diurnal clocks are congruent too. I have not gotten into diurnal clocks of organs yet but it is another sensitizer to the leptin system and very coupled to sleep. I fortell it a bit in my Leptin and sleep blog of last month. And John…….loved your questions. Thanks for the neuron exercise this AM.
@Andrea……Im working on a fix for your particular issue. And for your docs in Germany……give them my web address and tell them to read it. If they become interested I would be more than happy to speak with them or even put together some talks to help educate them. My goal is to change my profession. We need more docs to stop practicing cook book evidence based medicine and start practing using an evolutionary approach. If a dogmatic neurosurgeon can change on a dime I know anyone can if they just stop and THINK about what I am saying. Its not radical. Its in every textbook written but the message is just not conveyed well. To get it you have to read between many lines. That in essence is what the QUILT is. It is all the info in between the lines that is most critical to helping humans clinically. This is what separates my approach from the research bloggers in our community. I get to practice what I preach.
So glad i found this blog. I previously lost about 60 lbs (230 to 170) doing basic low carb diet. But for the last two years I stalled and regained about 10 pounds. Until about two weeks ago when I was able to start implementing the big breakfast and no snacking guidelines and I am now down about 5 lbs.
The bigger change for me is more mental though. I have long suffered from anxiety and panic attacks and food was a major stressor/stress reliever for me. I was literally snacking all day because I felt I had to do so to keep energy levels and perceived blood sugar in balance (although glucometer always showed tight blood sugar control, I "felt" like it was always low without frequent snacks – probably just related to anxiety state). What I have found now is that I don't have to snack, I don't have to reach into my pocket to grab a handful of almonds in the middle of a meeting, and I have a renewed confidence in myself which reduces overall anxieties.
With regards to the epigenetics, I don't know what my grandma ate, I am going to try to find out from my mom. She was a farmer and was not well off so I imagine she just ate whatever they grew. My question is whether there is a baseline diet that should be good for most of us to follow before incorporating any epigenetic clues into the picture which would start adding additional optimal foods to the diet?
Right now, I do best with eggs, beef, chicken, lots of salad and broccoli, a small amount of milk, but I get fairly weak if I don't add the occasional small red potato before a kettle bell workout.
@Jim……the point of bringing epigenetics up is that it is clear there is no one diet for everyone. The Paleo 1.0 books work for a large segment of the population…….but if you go to MDA and Robb Wolf's site you will see tons of people who are not getting optimal results with Paleo 1.0. the reason is their epigenetic switches are working against them. Once you eat to turn them off you can then retrain your body to respond to macronutrients as it was designed. Eating like a hunter gather now makes no sense unless you share their epigenetic signals as well. That is the point of Paleo 3.0. Where many will struggle with this is in its application. Its hard to do. And it is but it fully explains stalls and plateau's. If you eat paleo 2.0 like Kurt Harris suggests you likely do fine but you'll never get to optimal. Many people will be fine with that too because it is a simple approach. For the people who seek me out they dont want OK. They want to know why and how to do it. That is where the quantified self platform comes in. We look for why things are happening and reverse them. When I get to the Brain Gut series down the road you might be shocked to find out that Paleo may not be the optimal solution for humans.
my mother was born prematurely and her mother was always chubby. at age 5 my mother and her mother were Nazi POWs. my mother experienced times of starvation and as a consequence her trunk is too long for her legs. she had 4 children. she felt best and ate best during pregnancies 1 and 4: my sister and my youngest brother. these two siblings look most like my father and are obese. for pregnancies 2 and 2, my brother and I, my mother was very sick. she had pre-eclampsia (sp?) with me and mostly ate white bread she was so nauseous. surprisingly, my brother is 6'1" ,45 yo smoker with a few strands of grey hair and lean and well-muscled. i was over weight, but am not now due to paleo. we look more like my mother and have always been thinner than siblings 1 and 4. therefore, my hypothesis is that the contribution of the father's genes are equally important.
oops! some typos, but you can figure it out.
@ V…..the science does not support that but I bet your sibling epigenetic signals have overcome the preset of your grandmother and mom. I am going to post some more epigenetic information for you to ponder this afternoon when I can find it on my hard drive………I think these facts may open your eyes to the power or epigenetics
In the winter of 1944, as World War II was nearing its end, the Germans imposed a food embargo on a densely populated area of western Holland. At that time, the weather was unusually severe, agricultural land had been ruined by the war, and the people were already short of food. Some 30,000 people died. Pregnant Dutch women who starved during that famine but survived had smaller babies. That, of course, came as no surprise. But what was a surprise was that, when those babies grew up, even though the war was over when they were infants and they had been well fed and no genes had been tinkered with, they went on to have small babies themselves.
Detailed birth records collected during the 'Dutch Hunger Winter' allowed scientists to analyse the long-term health effects of prenatal exposure to famine. Not only have researchers linked such exposure to a range of developmental and adult disorders, including low birth weight, diabetes, obesity, coronary heart disease, breast and other cancers in that generation, at least one group has also associated exposure with the birth of smaller-than-normal grandchildren. This observation was made in 1944 even before DNA was found in 1953. Genetic determism is not the gold standard and never was. Epigenetics is now known to even control Telomere function via TERRA RNA. I will definitely be hitting that down the road.
Genes seem able to "remember" many things. For example in-vitro fertilization (IVF), which has become common these days. The temperature at which eggs and sperm are stored for IVF, the way eggs and sperm are handled, the atmosphere in which the procedure takes place, can all, through an epigenetic effect, determine the health and life expectancy of a child conceived in this way. The British press reported that Stephanie Mullins' first child, her son, Ciaran, who was the result of in-vitro fertilization was born with Beckwith-Wiedemann Syndrome. It is entirely possible that the IVF procedure was the cause of her son's condition as it has been shown that babies conceived by IVF have a 3- to 4-fold increased chance of developing this condition than babies conceived naturally. Another epigenetic effect that we did not anticipate based upon the central dogma of Watson and Crick.
Dr Rachel Yehuda, a psychologist at the Mount Sinai School of Medicine in New York, studied the effects of stress on a group of women who were inside or near the World Trade Center and were pregnant during the tragic events of 11 September 2001. Produced in conjunction with Jonathan Seckl, an Edinburgh doctor, her results suggest that stress effects can pass down generations. As late as December 2006, children of women who witnessed the Twin Towers outrage are still being born smaller than normal. It will be some time until those effects can be measured in the grandchildren of these women, but you can be sure that this will be followed up. Cortisol levels in the mother are huge factors. Remember every LR female who is pregnant likely has very high insulin and cortisol levels…..predicts huge numbers of type two diabetics who will get early heart disease and Alzheimer's Disease.
Thanks Dr. Kruse, I appreciate your help very much. I will definitively give the URL of your website to MDs who are open minded. The Quilt is one of my favourite blogs in the Paleo and health blogosphere, although I don't understand everything. I listened to all of Robb Wolf's podcasts but I that doesn't make me a biochemist or MD or biologist. I come from social sciences which means that I have a good bullshit filter for junk science.
I didn't believe my doctors and I looked for smarter docs. It makes things easier if I can cite "authorities" who say what I said for years. "Medicine is irrelevant" Prof. Walter Bortz II, M. D. Stanford Medical School. Dr. Bortz wrote a whole book about the outdated models of the industrial-medical complex.
http://tinyurl.com/6kd3qjq
After listening to your story on Jimmy's podcast I fed Google scholar with "leptin" and "cartilage". Maybe the leptin issue is the last piece of the puzzle for my big question:"Why?" Why did I develop chondropathia patellae? Maybe my mother was leptin resistant – she was very obese during pregnancy. Epigenetics? And I was not breast fed. Not good for my Leptin metabolism according to one study on mice. Maybe my metabolism is messed up epigenetically. Maybe it's just too much stress and bad nutrition in the past.
Ask any mediocre orthopedic doc "why" and he will be irritated or tell you the old mantra: "Aging" or "genes". Really? I am not old and nobody ever made a gene test on me. So where's the proof for your hypothesis? No help from those guys so I did my homework aka private research project. I already found stress hormones, muscle imbalances, bad coordination/movement patterns, nutrition and systemic inflammation as possible causes for joint problems.
Btw: I was always a proponent of epigenetics, long before the science came into existence. I knew from case studies in psychoanalysis and homeopathy that "uncurable diseases" can disappear. I never believed in genetic determinism and I smile when I see that science starts to catch up with me. As the saying goes: "If you sit by the river long enough, you will see the body of your enemies float by." But before I knew your story I never knew about leptin and joint problems. I was like: "Really? There is a connection? What the heck is leptin? "
Mainstream medicine starts thinking intelligently and looking for causes instead of pushing toxic drugs. Finally. My enemies are floating by…..:-) Prof. Dr. Henning Madry, Arthritis Research, University of Saarland, Germany said last August: "Osteoarthritis is no wear and tear but a chronic disease like asthma and diabetes. Cartilage is damaged by accidents or sports injuries but very often it is induced by internal processes which are not understood. Cartilage gets weak and finally destroyed. " This has nothing to do with aging per se. Many young people have OA today and many old people have no OA says Prof. Madry.
Woohoo! The boys grow up. They start looking for causes instead of looking for "treatments". So there is hope for a change in medicine. But I am afraid they will look for the next magic pill or treatment even if they find the causes. Changing lifestyle and food industry and farming and environmental pollution etc is just too inconvenient and -as Prof. Bortz puts it: "There is no money in it." And who is sponsoring studies, medical schools and medical journals? The drug industry and the food industry. It's a long way to go until I see these corpses floating by…….
Keep up the good work . I am looking forward to the growth of your QUILT which makes my brain twirling.
my paternal grandparents were farmers and both lived to 93. they were never obese. their 3 children are all obese. my father has always done hard physcial labor as a farmer, but was obese until he got a diagnosis of type 2 diabetes and changed his diet. so basically my father's lifestyle overrode his good maternal programming. i think that it what is happening all over. it doesn't matter how your mother and grandmother ate if you eat crap. bascially we have to carb restrict and pay attention to food quality and exercise until we feel better.
I'm a bit lost as to how this info can "help thousands".
Dr. K. Thanks for posting this. It is going to take an approach like this to iron out some of the questions we all still have.
Was I eating too much fructose? Perhaps. Or perhaps it was the combination of fructose with so much sat fat, particularly dairy, which, as you well know, is insulinogenic to boot. I think that is not a problem, per se, in most people so long as their metabolism is functioning correctly and their insulin surges are not prolonged to the point of having chronic high fasting blood glucose levels. Honestly (it hurts to be honest sometimes) I have never tested my own. I really have no idea what my BG levels are at any given time. After seeing my VAP results, I think it's time for me to find out how food really affects me.
Consider too, that my grandmother on my mom's side has been type 1 diabetic for decades. My grandfather on my Dad's side has been Type 2 diabetic for decades. He is still alive at 80 years old because he does a lot of other things right. My father was also type 2 diabetic and handled that terribly, using pure sugar and fructose as the fuel when he needed sugar even when I pleaded with him not to. He got a HUGE belly before he suddenly died in his sleep at 53 years old one night after a thanksgiving dinner that I hosted. So sad.
So am I willing to make changes? You BETTER believe it. I will do whatever it takes. I can tell you this… I haven't even so much as smelled a banana since seeing these results, and haven't had a drop of cream either. Butter consumption has plummeted to 1 tbsp total in the last 4 days. I am not convinced that tubers are a problem, so right now we will have to disagree on that one. Mostly because I do not believe starch spikes blood glucose long enough to be a concern. Also, since it's not fructose, it's not going to have the same affect on trigs coming out of the liver and into the blood.
HOWEVER, this is is all 'knowledge' that I am spouting. This is all 'theory' from me. Banking my decisions of theory of what everyone else says worked or didn't work for them is what led me here. That's why I think taking a look at yourself as an individual, considering all factors going for and against you, is the real answers to unlocking the door, to completing the puzzle. And this is what you are saying in your article above.
You make a comment above about hacking Jack Kronk, and I see some of the things you mention below that. Please feel free Doc. Lace me right between the eyes. I don't have much more data, but if you have any questions for me, I am here to answer. I don't understand all this stuff. I understand a percentage of it, and of that, much of it is fuzzy to me because I am just a normal guy on the internet who has read gobs and gobs and gobs and I combine that with my observations of what I have personally experienced in life and in addition to seeing what others have experienced. It's all I've got. That's why I appreciate people like you who have spent years understanding how this all works and are willing to piece things together with a no nonsense fresh look at everything.
Thanks for writing this Dr. Kruse.
Hey Dr. K, Todd here from PH. Is there any way I could contact you in a more confidential fashion? I tried to find a link here, with no success and PH does not have a direct contact function. Please let me know, Thanks.
@Jack Kronk – I highly recommend the BG monitor route. I was absolutely floored at my readings after buying one. And I've always been very athletic, in shape (so I thought) Absolutely eye-opening. The good news is, you're working from a solid platform, you stay informed, and you are open to new ideas, and you surround yourself with intelligent people, etc… Were I a betting man, I'd double down on the JK we all know having his ideal VAP numbers within a year or less. Cheers, bud.
@Tim….this is a difficult question Jack has asked the community at PH. I think thousands of people are struggling with the same issue Mr Kronk shared. I think the more we talk about it the more information is shared the better we can all think about Jack's problem. I think Jack's VAP results were not optimal even before his last one. I think that is why he really needs to think about the epigenetic switches his diet turns on and off. Maybe what he is currently doing is not optimal for him. Maybe it does not matter at all as long as he does many other things to protect his cellular terroir. This is a very difficult question for anyone to ponder hence why I think this issue playing out on the net could help many.
Todd you can email me at [email protected] The BG monitor is a great idea. This is part of what a quantified life is all about. The more data you have the better able you are to be informed………one bad side effect of more data is analysis of paralysis. Sometimes limiting choices leads to more satisfaction of the results. Sounds counter intuitive but there are books written about this paradox.
@Jack Kronk……contact me and we can talk about you. I think your old labs and new labs are quite similar in many ways but there is some concerns I would have if we had more data or knew more history…….which I do not. So speculation is not helping anyone. I think the greater point you have brought to this community is opening this discussion to the community. That to me is a great thing.
dr. kruse said: "one bad side effect of more data is analysis of paralysis…"
another bad side effect is the phenomenon of overdiagnosis. i believed the title of an interesting book on this subject is "Overdiagnosed".
Are there any programs that would help me track my blood work and compare it with the average for my age/sex/wt/ht etc? My doc doesn't have time to explain the details and I don't even know what questions to ask. I would like to be able to take all the confusing numbers and what appears to me to be gibberish, insert this info into a computer program, and have comparisons and explanations for each entry. Surely I'm not asking too much?!
I am an educated, intelligent social worker; however, I know virtually nothing about medical stuff. But I could figure it out, given time and all the info in one place. I don't have time to do internet searches for each detail.
Anybody know if anything like this exists?
@ Stacy There is not but I am working on a solution for this problem as we speak.
How do you explain significant differences in siblings?
My son and daughter had the same mother and maternal grandmother, obviously. They ate, or at least were served the same food.
My daughter is 24 and slim. No weight issue.
My son (28) was slim up to age 6 then suddednly his one summer he gained lots of weight. (There were many other changes at this time, his marks went down, he lost his confidence – a real personality change).
My son is overweight. If he really sets his mind to it, he can lose (trying to get him onto paleo) but it is unbelievable how quickly he puts it all back on.
How do you explain the difference in terms of epigenetics?
Thanks. I enjoy following your blog.
Hi, please could you clarify what you recommend that we do with the info about our mother's and grandmother's diet. Does it tell us how our body expects to be fed, how not to eat, what? My mother and grandmother both ate a traditional British diet of meat, potatoes and veg plus regular desserts.
@Ruth…….Yes he likely became Leptin resistant once he gained his weight and his own choices flipped his switch and overcame his pre programming. I bet if you look back then his sleep became disordered too and his moods changed. All classic finding in LR. LR often begins in an altered gut flora.
@K. It helps explain where you may want to start with a food fuels. If your Grnadmother and mom were obese eating the SAD or ADA for diabetics will make you fat and sick. A low carb Paleo diet likely would be the ideal choice. If you mom and grandmom were slim and fit you likely could get away with a SAD until your hormones begin to fail at 25 years old. This information is useful in drawing inferences into what may hurt you and cause stalls or plateaus. I believe we can predict how we will respond to certain foods based upon the knowledge you get from grandmom or mom. Its not 100% because your own choices made will have a great effect on your phenotype. But if you have overweight parents feeding a child similac and grains will likely lead to diabetes by 20 yrs old and heart disease early and early onset AD. That maybe a case to buy term insurance and long term care coverage early in life. Yes I do think like that.
1. I am trying my best to understand this as a current M2, but if you ate a SAD diet, wouldn't it make sense that epigenetic changes that occur should be trying to benefit you? why would it accelerate development of chronic, modern diseases from newer generations?
2. Through your research and realization of Paleo 3.0, you're starting to sound similar to Metabolic Typing haha. Do you have any thoughts on MT as a budding science? Esp as it is used by oncologists
@ Dan Hen 1. It would if there were things in the SAD that caused good adaptations. I dont think there are any based upon neolithic disease prevalence for the last 125 yrs. The only thing I can see is that some humans appears to tolerate grains OK without any major issues. However, I say that because I think we are not looking at correct things with respect to grains.
2. How oncology uses it and how I am describing it are apples and oranges. I think epigenetics is a type of MT. In fact I do believe each one of us has the best diet for us to eat based upon the switches we have turned on. Interestingly enough, we can change those switches with our choices. That is really what I have found and what is the foundation of Paleo 3.0.
I just read your blogs on Leptin and Sleep. I don't find a way to comment there, but since you mentioned sleep disturbance in reply to Ruth, I'll ask my question here. What if sleep is disturbed chronically due to chronic pain? How can we get into good sleep patterns where the signalling will improve if we can't sleep through the night? I have a friend, for instance, who states she never gets into REM sleep do to waking before this begins, all night long. What is the solution to this problem? Will the Leptin Prescription eventually resolve this?
… speaking of no way to comment on your blogs on Sleep … when attempting to search the blog for specific topics, the search bar is inactive. Can Word Press make that work? The Quilt is getting big quickly and it'd be very good to do a search to find which blog discussed what as I tell my friends about your information and I want to go back to verify what I'm telling them. Can't find it easily.
I just found your blog on the web yesterday. I have a lot to say from my personal experience of the last 55 years. At 70 years of age, I am doing better than since I was 15 years old. At 15 I had a ruptured appendix that was untended for 2 days. This was a near death experience for me and changed my health forever. I was in & out of hospitals for years. Did not think I would live to 30. However at 70, I have lived longer than my Dad, his Dad, and his Dad's Dad.
The short version of my journey is that I evolved in to Paleo 3 eating on my own over decades. I have journals & records to share with this blog, if there is interest.
Today I am 170 lbs at 6"1"with BP 110/65, A1C 4.8%, but high TC 348, HDL 86, TG 49, calculated ldl of 253. My Dr gave me a script for Niaspan, which I no longer take. When I see him in August, I am going to ask for a VAP panel. Heart scan calcium score at age 61 was 1.0.
Both of my Grandmothers & Dad passed from diabetic complications. Both of my Granddads passed (in their 30s & early 50s) before I was born.
I think you are right on the money with this blog.
The maternal grandmother/mother connection is interesting. I know my grandmother grew up as a well-to-do first generation German Immigrant in the Cleveland, OH area born in 1898. I know they had servants and ate very well. She was also thin from what I can tell in the old pictures. When she married my grandfather, she was banned from the family. She also never learned how to cook and my mother grew up dirt poor and I think my mom said they lived on coffee and milk so I am going to presume this was grandma's diet. I know she ate little meat but tended to eat carb heavy and was thin. My mom was thin, ate a pretty even protein to carb ratio and I'm fat. If you look at pictures, I tend to take after my paternal grandmother more than maternal physically. Basically, built like woman meant to pull plow. What gives?
@Bob your story is amazing and I would love for you to send me anything that I could use to help others like you. You can email me at [email protected]. Your post made my day sir. This is precisely why I put the time in to this. To tell people why this happens to us.
@Georgette Sound like they may have had high rev T3 from starving. This may have turned off their epigenetic switches to IGF pathways and made your metabolism exquisitely sensitive to carbs because they saw so little of them. That could have set the stage for PCOS when your epgenetic signals turned on those switches in a big way during your first twenty years of life. Go read about the Dutch Winter. This is precisely the mechanism that was in play in 1944 during WW 2 in Amsterdam under German occupation.
What are we to look for in our mother's and grandmother's figures during pregnancy? My great-grandmother ate traditionally made food (but a good bit of flour & sugar, too) and was plump. My grandmother was offered great farm-fresh food her whole childhood, but was extremely picky and ate mostly bread. My mother ate junk most of her growing up years, with slightly more real food as she got older. She was thin her whole life.
Till the 80's. Then they all became obese. I was plump as a toddler, thin as a kid, teen, and young adult, then gained weight after several years of increasing sugar addiction, despite switching to a traditional foods diet during that time.
I believe "You are what your grandmother ate," absolutely. But I think you may be oversimplifying it a bit. What she ate definitely shaped my mother's conception and my own. But what *I* eat can overcome that in some ways, although not in others. For instance, I can be born with a predisposition that *if* I eat poorly, I'll get lots of cavities (while my friend's predisposition is that if she eats poorly, she'll get lots of allergies and no cavities). But as long as I eat well, none of that comes out. And if it comes out, but I change my diet, I can stop it.
On the other hand, if my predisposition is to poor jaw formation if my *mother* ate badly, as far as I know, there is nothing I can do to change that.
Weston Price found this nearly a century ago. We're just now getting it into our skulls today!
I also think we have to discuss what parts of diet are universal and what are up to genetics. All of us need to avoid processed food, and all of us need to get lots of fat-soluble vitamins, etc. But it seems clear some of us are okay with moderate carb levels, while others need very low carb levels. (Clearly, high levels are good for no one.)
I think it's still up in the air why. Are those whose ancestors are from tropical regions more likely to do better with more carbs? Is it truly just passed along your maternal line, and if so, what explains differences between siblings? (I think it's explained by the same thing that explains differences in appearance – *some* parts of the equation are passed down the maternal line, but others are a combination that will depend on the unique zygote formed at your conception.) Is it a function of the recently discovered three types of gut ecosystems? Is it related to your current hormonal status (but once you get that fixed, perhaps you can return to perhaps 50-150gm/day?)?
I don't find the Dutch starvation issue surprising – fascinating, but not surprising. But I don't think it is evidence that everything having to do with epigenetics is from your maternal line. Clearly a poorly fed father can and does affect offspring's health. Price's research showed this, as well. It may not be able to affect *all* aspects of health, but it clearly affects health. Traditional societies fed both men and women traditional superfoods for six to 18 months prior to a likely conception. Not just the women!
It would be helpful to determine which things (like cavities) can be inherited as a weakness but can be stopped if we eat well, and which things (like narrow palates) cannot. It would be helpful to determine which types of people can do okay on more carbs and which people cannot. It would be helpful to determine whether or not the ability to tolerate moderate carbs can change over the course of a lifespan.
In the meantime, I'll keep reading my body's signs, as usual, and stay VLC, which is the only way I can keep sugar cravings at bay.
Dr. Kruse,
I've asked a question about our son and what should he be eating. One important part I left out and now want to know if it changes your previous advice. You suggested paleo diet with 150gms and lower it by 20gms until he feels good. He was breastfed close to a year, I have two brothers with schizophrenia, and my mother was sick most of her pregnancy with me. He's ten now, but when he was three, he had three grand mal seizures in a day. He went on the lowest dose of Depakote and after a year, his EEG was normal. No problems since then. Does he have a "bad brain" and need the ketogenic diet or does the 150gm/day and lower it as necessary still apply? Thanks.
Have you done any research on fecal transplants? Is it possible to replace your gut bacteria from your mom who is unhealthy with say your father via fecal transplant who is healthy?
@Matthew I have a few people who have serious crohns and IBD who have failed conventional and primal remedies to help this and they want to know if they should travel to get in a research protocol to get this done…….right now I am in reading and researching mode so I am not yet ready to make a proclaimation but this I will say now…….if you are one of these people currently you are slowly dying every minute of everyday and I think you should consider every chance at recovery you might have. The brain gut axis is levee 5 in my quilt so obviously it is a vital thing to protect in my opinion. With what I have read so far I am very supportive of the idea and science behind it. I have a personal friend who had bad IBD who has failed everything and he is scheduled to get the transplant in January 2012 and will be the focus of one of my future blogs.
@JS http://www.livescience.com/7736-epigenetics-revolutionary-humans-work.html
Dr.Jack,
do you take new patients (or any for that matter?)
I don’t fit into any box health-wise (POTS, Mal de debarquement symptoms, CFS, brain fog etc.) body type-wise (106-108lb) and lab-wise (significantly elevated lipids and bilirubin, which go slightly up and down in a tandem); weird D25 and D1.25, elevated copper, MTHFR snps etc., yet I hardly ever get respiratory infection, wounds heals superfast andI look at least 10 years younger my age (55).
I have tried everything there is to try, nothing makes any difference. I am ready to give up as this is not the way I want to spend the rest of my life-alone, socially isolated (family is thousand miles away) and mostly in bed wishing I was dead.
I would ask someone to drive me to the NewOrleans if it comes to that (I live in SW Fl).
I need someone to figure this out. Thanks
Nat I only do educational consults for my members.
I had a telephone consult with Chris Masterjohn, he suggested some Cyrex lab tests, but could not form his opinion about the cause of my health issues. My POTS was diagnosed as normatensive, yet I passed out during TTT with HR 146. I allegedly have hypovolemia?!!? I can’t try any detox protocol or supplements it makes me feel 10 times worse. I have not been on a boat to have MdDS symptoms. My sister got rid of an itchy cough that she had for years on and off with just one dose of LDN, 3.5 mg., yet I am unable to take LDN and does something to my brain that I turn into a semi-conscious-zombi. I have severe episodes of lethargy, regardless of what I eat, being semi-comatose for hours. I started CT-face and then pour over myself the water with ice, yet this feels good, but gives me no energy or any benefits. I am literally ready to give up for I don’t know what else to do. Thanks
p.s . just 5 years ago I was a successful CPA, and got my license at 46 years old passing CPA exams.
This sounds like a severe form of EHS. You need to hack your local living and work environment before you do anything else. Read the Reality 3 blog and consider looking into our the EMF boot camp on this site if you need further direction.
Thank you for the direction Dr. Jack, I will look into everything you are suggesting here. Listening to your Vermont presentation at this moment. I am on disability.