For today’s edition of Dear Mark, I’m answering several questions drawn from the comment board of last week’s post on fasting vs carb restriction. First, how do I square my recommendations with the successful reports of potato dieters losing weight on a high-carb tuber diet? Second, is Leangains optimal for mass gain? Third, how do I use extra virgin olive oil, butter, and ghee? Fourth, could exogenous ketones help a man with dementia, MS, and seizures? Fifth, how should a woman with stalled weight loss integrate fasting?

Let’s go:

Walter Sobchak asked:

If “carbs” are so bad, how do people eat only potatoes and lose large amounts of weight? Andrew Taylor (SpudFit.com) and Penn Jillette (Penn & Teller) are two high-profile people, but there are lots more. Of course, I wouldn’t recommend an unbalanced diet of only one food, but the point is that potatoes are a natural food and are not inherently detrimental.

I agree that potato-only diets are a quick weight loss hack.

Potato-only diets work well because they’re so monotonous. When your only option is a plain potato, it’s extremely hard to overeat. It’s the combination of fat and carbohydrates that’s so easy to overeat, and that causes the most metabolic problems.

Potatoes are surprisingly nutrient-dense. They have complete protein, containing all the necessary amino acids. You won’t be bodybuilding on all-potatoes, but there’s enough protein in there to stave off muscle loss for a week or so.

Cooking and cooling your potatoes converts some of the glucose into resistant starch, which feeds your gut bacteria and cannot be digested by your body. This lowers the effective glucose load.

I could recommend the potato-only diet, ditch the keto/low-carb/Primal talk, and people who listened to me would still lose weight. But they’d miss out on all the other benefits, not least of which is the delicious food. In short, the potato-only diet isn’t the worst thing out there, but I wouldn’t recommend it as a long-term strategy.

Check out what I’ve written about potatoes in the past. You might be surprised.

Mattias Carlsson asked:

I have a question for advice if someone know. According to most sources I find the so called anabolic window persist at least 24 hours after resistance training. How can then an intermittent fasting with 8 hour eating as in lean gains, from what I understand, be optimal on training days. It seems to me that a bit of overeating on carbs and protein during all this time would be most beneficial?

I don’t know that it’s optimal for sheer mass gain. But it does seem to strike a nice balance between “gains” and “staying lean.” You may not bulk up as quickly as you would cramming food in your gullet. You will gain lean mass without gaining so much of the squishy mass that normally accompanies what passes for “gains.”

Michael Levin wondered:

Question: EVOO, Ghee and grass-fed butter–which to use when and for what?

EVOO: salads, marinades, sautéing. It’s actually far more resistant to heat than most people think; the polyphenols protect against oxidative damage.

Ghee: Indian cooking, Thai cooking, high heat searing.

Butter: Cooking eggs and other breakfast items, melted with broccoli/shrimp, finishing steaks and reduction sauces.

Beth Olson asked:

What are your thoughts on exogenous ketones? My dad has MS and dementia and seizures way too often. Should we try adding these?

I can’t give your dad any medical advice. You can talk to his doctors, however, and show them this study where exogenous ketones reduced seizure activity in mice. You can show them that coconut oil and MCT oil—two other routes for generation of ketones—have shown efficacy against cognitive decline in patients with Alzheimer’s or dementia.

I suspect exogenous ketones can help. I also suspect they’d be far more helpful on top of a low-carb, high-fat diet with plenty of healthy lifestyle modifications.

That’s the thing with dementia: there isn’t a pill that fixes everything, or even a single intervention. In the one study that actually got major results, researchers had Alzheimer’s patients undertake a dramatic diet, exercise, and lifestyle shift. Here’s what each subject did:

  1. Eliminate all simple carbs and follow a low-glycemic, low-grain (especially refined grains) diet meant to reduce hyperinsulinemia.
  2. Observe a 12-hour eating window and 12-hour fast each day, including at least three hours before bed.
  3. Stress reduction (yoga, meditation, whatever works for the individual).
  4. Get 8 hours of sleep a night (with melatonin if required).
  5. Do 30-60 minutes of exercise 4-6 days per week.
  6. Get regular brain stimulation (exercises, games, crosswords).
  7. Supplement to optimize homocysteine, vitamin B12, CRP levels.
  8. Take vitamin D and vitamin K2.
  9. Improve gut health (prebiotics and probiotics).
  10. Eat antioxidant-rich foods and spices (blueberries, turmeric).
  11. Optimize hormone balance (thyroid panel, cortisol, pregnenolone, progesterone, estrogen, testosterone).
  12. Obtain adequate DHA to support synaptic health (fish oil, fish).
  13. Optimize mitochondrial function (CoQ10, zinc, selenium, other nutrients).
  14. Use medium chain triglycerides (coconut oilMCT oil). You could possibly use exogenous ketones here too.

Bring that study to your dad’s doctors and see what they have to say. If they aren’t blown away by the possibilities and open to give it a try, I’d be shocked. Hopefully your dad is game. I’d love to hear how it works.

Lisa Chupity asked:

I went Primal/Paleo back in March of 2012. I lost the 15 pounds I wanted to lose. In 2015, 7 pounds crept on, and for the life of me, I can’t lose ‘em! April of this year, I went Keto. I track my macros, and do my best to keep my carbs to 20 grams per day, tho I don’t beat myself up if I have 24. I haven’t lost an ounce! I’m going to have to do the IF thing, I’m sure. As it is, my breakfast is bone broth (1 1/2 cups) and a mug of Coffee with Brain Octane in it. Lunch is yer basic “Big Ass Salad”. Dinner is good, too, and within Keto guidelines. I try to keep my caloric intake to ~1600 calories/day.

To add to the mess, I have Multiple Sclerosis, so stuff like Cross Fit is outta the picture. I can manage some stationary cycling, and some Pilates, with lighter modifications. Any advice?

If you try IF, do the “early restricted feeding” rather than late. You’re already doing a kind of “fast” in the morning, just drinking broth and coffee with MCTs, and it doesn’t seem to be working.

Eat some fat and protein for breakfast with a few carbs. Eggs and bacon with a side of cantaloupe or berries. An omelet with spinach and onions and cheese. Steak and greens and half a banana. Emphase whole-food fat and protein. Have coffee and broth, too, if you like. This and lunch should be your biggest whack of calories.

Eat your Big Ass Salad for lunch. Drop dinner, or make it really light and no later than 5 or 6 PM.

Terry Wahls has a great Primal-friendly MS protocol. Check out her Ted talk and go from there if it interests you.

Good luck and keep us apprised of your results.

That’s it for today, folks. Take care, be well, thanks for reading and writing!

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The post Dear Mark: Potato Diet, Lean Gains, EVOO/Butter/Ghee, Exogenous Ketones, and Early IFing appeared first on Mark’s Daily Apple.

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inline Fiber.jpegThe tricky thing about fiber is that it’s not a monolith. There are dozens of varieties. Some of them perform similar functions in the body, but others have extremely unique effects. Some rend your colonic lining to stimulate lubrication. Some turn into gelatinous slurries. But we can’t talk about fiber without understanding that the word describes a variety of compounds. As such, anyone making declarative statements about “fiber” without differentiating between the different types and their effects isn’t being accurate (except for me in that exact sentence).

This leads to a lot of confusion. People make blanket statements that might be true for some types of fibers and incorrect for others. 

Today’s post will attempt to illuminate the bulk of the matter. I’ll go through some of the most common misconceptions and myths about fiber from all corners of the dietary world. Whether you’re keto, low-carb, vegan, carnivore, or breatharian, you’ll find something to love and hate in today’s post.

1) “Fiber makes you full.”

This is theoretically sound. Mechanoreceptors in the gut respond to physical fullness by triggering satiety hormones. Big loads of insoluble fiber increase intestinal bulk, while some soluble fibers can gel up and increase the size of the stuff moving through your gut. Both result in added pressure on gut mechanoreceptors.

How does it work in practice?

A review found that while soluble fiber reduced appetite more than insoluble fibers, the overall effect on body weight was quite small, unimpressive, and inconsistent. More recently, a soluble fiber supplement failed to have any effect on satiety hormones, appetite, and subsequent food intake for the first 150 minutes after eating in healthy adults. The plucky researchers aren’t giving in, however, promising “further research… to quantify how soluble fiber influences appetite several hours after consumption.”

Resistant starch, an indigestible type of starch that colonic bacteria ferment, on the other hand does appear to increase satiety in humans, reducing food intake by 15%.

2) “Every diet needs the same amount of fiber.”

As it turns out, fiber becomes more critical the more carbohydrates you eat.

Soluble fiber slows down digestion, reducing the rate at which energy is absorbed. This can be helpful for people with glucose intolerance or type 2 diabetes by slowing the release of glucose into the blood. 

The byproducts of fiber fermentation in the colon by gut bacteria often have beneficial effects on carbohydrate metabolism. Eating resistant starch, for example, lowers the postprandial blood glucose spike. This reduction may also extend to subsequent meals, indicating it’s honing your ability to handle glucose. Everyone can benefit from better glucose management, but it’s far more critical for people eating significant amounts of glucose.

3) “All the healthiest people studied eat fiber!”

Observational studies are fun and all, but they’re not a good way to prove the healthfulness of fiber. Looking at fiber intake is just about the best way to capture the “healthy user”—that person who does everything right, like walk daily, exercise regularly, abstain from tobacco, avoid binge drinking, and eat whole foods rather than refined ones. It doesn’t say anything definitive about the health effects of the specific dietary variable they’re observing.

That said, the fact that most healthy populations eat whole foods containing fiber indicates that fiber probably isn’t actively harmful.

4) “Fiber is just roughage for big impressive poops. No functional use.”

That’s mostly true of insoluble fiber, which is pure waste material that shreds your intestinal lining and increases stool volume.

There’s considerable evidence that people with type 2 diabetes can really benefit from prebiotic fiber supplementation:

  • Chicory-derived inulin, a potent prebiotic fiber, reduces liver enzymes and HbA1c, improves blood pressure and fasting glucose, and increases calcium homeostasis.
  • Inulin improves immune markers and glycemic control.
  • Resistant starch lowers insulin resistance and inflammation.

A review of studies found that while the prebiotic inulin reduces LDL-C (an imperfect biomarker of dubious utility) in all populations, only in type 2 diabetics does inulin improve HDL and blood glucose control. 

Prebiotic fiber may also help certain patients with non-alcoholic fatty liver disease (NAFLD). The usual therapy for NAFLD patients is weight loss. You lose enough body fat elsewhere and the fat you’ve accumulated in the liver starts to disappear, too.

What about lean NAFLD patients without any real weight to lose?

In lean patients with NAFLD, a synbiotic—blend of prebiotic fiber with probiotic bacteria—reduces liver fat and fibrosis by improving inflammatory markers. Pre-emptive consumption of prebiotics may even protect against the development of NAFLD.

Another function of fiber that occurs in everyone is the production of short chain fatty acids by gut bacteria. When gut bacteria ferment prebiotic fiber, they produce short chain fatty acids, many of which have beneficial metabolic effects.

Butyrate is the most important short chain fatty acid. It fuels colon cells and may prevent colon cancer. Its relationship with existing colon cancer cells is more controversial. Read more about that here.

One interesting line of research is studying the interaction between the ketone body beta-hydroxybutyrate and the short chain fatty acid butyrate. Initial indications suggest that the two may have synergistic effects on cognition, inflammation, and overall health. That alone may be a reason to make sure you get prebiotic fiber on your ketogenic diet, just to hedge your bets.

Now, might a low-carb or ketogenic diet work better for people with type 2 diabetes than adding fiber to their normal diet? Sure. Could such a diet reduce the need for fiber? Yeah, I could see it. The same goes for NAFLD—low carb diets are also excellent in this population. And perhaps people who aren’t eating so many carbs don’t need the short chain fatty acids to improve their metabolic function and insulin sensitivity. But the evidence for fiber in type 2 diabetes and NAFLD stands, and I suspect short chain fatty acid production matters even in low carb or keto dieters.

5) “Fiber cures constipation.”

It depends.

In one 2012 study, patients with idiopathic constipation—constipation without apparent physiological or physical causes—had to remove fiber entirely to get pooping again. Those who kept eating a bit or a lot of it continued to have trouble evacuating. The more fiber they ate, the worse their constipation (and bloating) remained.

A 2012 review found that while fiber may increase stool frequency, it doesn’t improve stool quality, treatment success, or painful defecation. Similarly, glucomannan, a soluble fiber, moderately improves defecation frequency in constipated kids, but has no effect on stool quality or overall treatment success.

However, galactooligosaccharides, a class of prebiotic fiber, do appear to improve idiopathic constipation. And inulin, another prebiotic fiber, improves bowel function and stool consistency in patients with constipation.

6) “Fiber aggravates gut issues.”

Some say fiber cures gut issues like IBS and IBD. Others say fiber aggravates them. Who’s right? Maybe both.

Both IBS-D (irritable bowel syndrome with diarrhea) and IBS-C (irritable bowel syndrome with constipation) patients can benefit from soluble fiber (psyllium) while insoluble fiber (bran) is far less effective.

Wheat bran works okay for IBS, if the patients can tolerate it. They tend to tolerate something like hydrolyzed guar gum much better.

For IBD, the evidence is mixed. One survey of Crohn’s patients found that those eating more fiber (23 grams/day) had fewer flareups than those eating less (10 grams/day), while colitis patients reported no difference in symptoms based on fiber intake.

On the other hand, studies indicate that a low-FODMAP diet, which eliminates most sources of fiber, especially fermentable prebiotic fiber, is an effective treatment for IBS and IBD. Low-FODMAP diets have been shown to reduce bloating, abdominal pain, quality of life, and overall symptoms in intestinal disorders.

These contrary results may not even be contradictory. If your gut’s messed up, one solution could be to add back in the fibers you’re missing. Another could be to take all the fiber out and start from scratch.

7) “Fiber reduces nutrient absorption.”

For a long time, the consensus was that fiber tends to bind with minerals in the gut and thus reduce their absorption. These days, researchers understand that many of these fiber-bound minerals become available after fermentation in the colon.

Another wrinkle is that dietary fiber often comes with phytic acid, which binds minerals and prevents their absorption. Take wheat bran. Often deemed “wheat fiber” and lambasted for its tendency to bind minerals, wheat bran isn’t just fiber. It’s also a significant source of mineral-binding phytic acid.

Prebiotics increase absorption of magnesium, heme iron, and calcium. This makes sense. Even if the prebiotics are binding minerals, they release them once they reach the colon for fermentation by gut bacteria.

Fiber may reduce absorption of plant polyphenols, however.

8) “No one needs fiber.”

On the surface, this appears to be a sound conclusion. The human host digestive system cannot digest it. The majority of the fiber we eat gets pooped out as literal waste material. Certain classes of fiber may improve our gut health, but no one is keeling over from a lack of fiber in their diet.

Some have argued that a sterile gut is ideal if you have the right diet, that employing vast hordes of gut bacteria is just an adaptive measure taken to deal with a substandard diet full of roughage. The problem is that most people throughout history and prehistory have eaten that roughage, employed those gut bacteria, utilized the metabolites those bacteria produce. I suspect thinking long and hard before you consider it immaterial to human health.

If that were true, why would breast milk—the only food specifically designed for human consumption—contain loads of indigestible oligosaccharides that feed the growing gut biome? Even if it turns out that feeding the gut biome is only vital during infancy, that’s still a population of humans who truly need fiber.

Here’s where I come down: Fiber is an intrinsic part of many whole plant foods (and even whole animal foods, if it turns out that our gut bacteria can utilize “animal fibers” like other top carnivores). The Primal-friendly plants, the ones our ancestors grew up eating approximations of, like fruits, vegetables, roots, and tubers, are mostly higher in soluble fiber and lower in insoluble fiber. The only way to get huge doses of insoluble fiber these days is with supplementation or by eating grains. I don’t suggest eating grains or supplementing with insoluble fiber. I do suggest eating fruits, vegetables, roots, and tubers (while managing your carbs).

As for the carnivore issue, I’m open to the possibility that a properly-constructed carnivorous diet (which may, remember, include gristly animal fiber) obviates the need for plant fiber, prebiotic or otherwise. I’m not confident enough to try it myself, though.

Do I think everyone should be supplementing with prebiotic fiber? No. I add inulin to my Primal Fuel protein powder, mostly to improve mouth-feel but also to feed beneficial microbes and increase butyrate production. I add prebiotic cassava fiber to my collagen bars, again to improve texture and feed gut bacteria. And I’ll sometimes use raw potato starch for its considerable resistant starch content, often just mixing it into sparkling water and drinking it straight. But for the most part, the fiber I eat is incidental to the foods I consume. Berries, non-starchy vegetables, jicama, garlic, onions, green bananas, nuts—these are all foods rich in fiber, particularly prebiotic fiber, and I eat a fair amount of them while remaining low-carb and often keto.

As you can see, the fiber story isn’t simple. At all. There are many variables to consider. If you’re confused and unsure of how to think about fiber, you’re on the right track.

What do you think, folks? How has fiber helped or harmed you? I’d love to hear from everyone.

Take care and be well.

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The post 8 Misconceptions About Fiber appeared first on Mark’s Daily Apple.

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