Nitrogen in Your Bones Will Tell You How Much Meat You Have Eaten
What we call modern civilization is the historically recent phenomenon of the industrial revolution wealth imposed on agrarian populations that have moved into large cities. This has all happened in the last 150-200 years. Our grandparents, or at least their parents, were almost all farmers. If one asks, "What did they eat?", we have to dig back to those meals at Grandma's house and try to remember what her home-cooking was. And if we follow that trend further back, in just 5-7,000 years we find the time when we humans transitioned from being hunter-gatherers to farmers. What did they eat? What diet is the healthiest? What diet makes humans the healthiest?
What did the hunter-gatherers eat? We don't know. All we know is that when we measure their skeletons, they were taller than we are with larger brains, stronger bones, fewer infections, and no evidence of diabetes. Sounds healthier! Hmm, there are those who claim that moving from the healthy state of hunter-gathering to farming was the greatest catastrophe for humans other than the Pop Tart and the mullet haircut. That move, however, did provide for food security, cities, written language, pyramids, and iPads.
There are populations on planet earth that we have studied in just the last 100 years who are still essentially, hunter-gatherers. They have been studied in detail and often show a markedly different diet than what we term healthy. For example, Weston Price in his travels around the world described the Northwest Pacific coast Indians who harvested the ooligan, or candlefish, which is a smelt family, very high-fat fish. They dried it and used it as a trade item. Blocks of the fish were found hundreds of miles inland. It was their dominant food. Stefansson and Jorgenson famously lived with the Innuit for 5 years and didn't touch one vegetable or fruit and came home healthy and vibrant. When they returned to report their findings in New York, no one believed them and were convinced they would have died of scurvy. To prove their research, they lived in Bellview Hospital for a year and were tested daily to prove they hadn't cheated. All they ate was meat and fish for one full year and came out just fine.
When I hear "just meat and fish," I think of a diet that is 100% protein. The human body can only absorb so much protein. About 40% of your diet is the max you can absorb. You do need protein and it is good for you, but you have to chop it up and get rid of the amino (nitrogen part of it) component before you get energy. That means you need to get the remainder from elsewhere: either carbs or from fat. FAT. That is what the Innuit and the NW Indians were after. In fact, Stefansson described the Innuit as slaughtering caribou and saving the meat for their dogs in the permafrost. They went after the organs and the fat. And a whale or a seal, how there was a bonus because all that blubber was delicious fat. They knew they shouldn't eat that much protein. This same pattern has been observed in every hunter-gatherer society ever studied. The Massai in Africa, the aborigines of Australia, the Hazda of Tanzania. They prefer animal calories if they can get them, and the best part is the fat.
Now, can we take that knowledge and ask the question, "How much meat did our ancient ancestors really eat?' Yes. We can answer that question.
Turns out Nitrogen, Carbon, Phosphorus, Oxygen all come with different isotopes that are absorbed by plants and animals at different rates. What you eat turns into who you are. Your diet becomes your bones. We can look at your bones and measure those isotopes with incredible detail. Normal nitrogen has a molecular weight of 14 daltons but N15 (one extra neutron in the nucleus) is also around in smaller amounts. It gets concentrated up the food chain by plants, and then animals. Top predators have the highest levels. Plant eaters have lower levels. Same with fish. The higher you are on the predator scale, the higher the N15 is in your bones. This becomes an accurate measure of the quantity of animal protein versus vegetable protein in your diet.
Guess what we find in the bones of Neandertals and pre-history humans. You got it. Very high levels of N-15. Neanderthal bones have higher N-15 than hyena or fox bones at the same sites. Early humans were apex predators. And they ate animals, first and foremost. Vegetable matter is what you eat when the hunt failed or for the few weeks a year when the mulberry tree is ripening (or whatever plant source was in your neighborhood).
Our fore-parents were not idyllic vegetable eaters. We left that table when our brains began to evolve and become larger. That was some 2-5 million years ago. All the other hominids have primarily vegetarian diets and have bodies accommodated to that. But humans have changed to be meat and fat eaters. We can't eat too much protein, so fat it is. The stomach pH of a chimpanzee is 4.0. Human stomachs have a pH of 2.0. That is 100 times more acidic. Very high acid is good for breaking down protein. Low acid is good for plants. Humans are designed to eat animal. As much as we can successfully hunt.
Isn't that interesting? Doesn't it change your perception of what a healthy diet might be? But we have been told to avoid "saturated animal fat like the plague". We believe it raises your cholesterol and causes heart disease. Is there nuance to that fat story? You bet. Big time. Next week.
www.What will Work for me? Well, hunting has changed. I only have to walk to the fridge to find cheese, milk, eggs, and with Uber Eats, all I have to do is pick up the phone and in 20 minutes, I can have a bucket of something meaty. What I am recognizing is that we most certainly need protein, but there is a limit to how much protein we should eat. But, fat, there is no limit. It isn't bad for us, if it is "natural fat". The problem comes with the loss of natural fat. That's next week.
1. What isotope of nitrogen can we measure in bones that reflects the amount of animal protein in the diet of the bone-owner? Answer: N-15
2. What happens to the level of N-15 as one goes up the food chain to predators? Answer: The higher order predators have more N-15. Apex predators have the most. Imagine T. rex.
3. And what apex predator have studies proven to have been at the top? Answer: Humans. Even tigers and lions are lower N15 because they eat herbivores that have less.
4. What it is in animals we like the best? Answer: (Clue -what food element can chefs add to any meal to make it taste better). Butter or bacon. Fat.
5. Is there any harm to eating more fat? Answer: Next week. It's all about the fat. Saturated fat is not normal in any animal. Omega fats are healthy as they can be. Our modern meat has been turned against us. Next week.
Waist to Hip Ratio Gets it Right
If it isn't one humiliation after another? But as we get older, we get saggy in all the wrong places and start to put on tummy fat. It's a very expensive test to do a body fat measurement with a DEXA scan. And the BMI (Body Mass Index) that has been our time-honored method of measurement just plain has flaws. Too many folks with good muscle mass look like they are obese on BMI. (Method to calculate BMI: (Wt in lbs)/(Height in inches*(Height in inches) all times 703. Under 25 is considered goal. Over 30 is obese. Under 19 is too skinny. Sweet spot, supposedly 22). That leads to some general skepticism.
Belly fat is dangerous stuff. We now know that you release a whole slew of inflammatory cytokines from that fat which makes your belt size bigger. Whether it be from the effect of the inflammatory foods we eat and therefore react to, or from the nature of fat cells in your belly fat, we aren't too sure. We do know that metabolic syndrome is partially defined by that too. Men should have a waist size under 40 inches, women 35 by those criteria.
Well, now we have proof that there is a better method that is just as easy to do. In fact, easier. All you need is a tape measure and a private bathroom. Measure your tummy around your waist at the level of your belly button just after breathing out, completely relaxed. Then, measure your hips at their widest place. Divide tummy circumference by hip circumference. Your goal is to have Men at < 0.9 and Women at < 0.85.
The proof comes from the American Heart Association Journal publishing the results of the MONICA Risk, Genetics, Archiving, and Monograph (MORGAM) Project. It combined the data from 30 populations in 11 countries; 90,487 men and women, aged 30 to 74 years, predominantly white, with no history of cardiovascular disease. They were recruited from 1986 to 2010 and then followed up for up to 24 years. Pretty good numbers. Over that time period of observation, there were 9,105 deaths. Mortality is something easy to define. That's hard data and what you are most interested in.
What they found was revealing. For all hip sizes, having a smaller waist was strongly correlated with reduced mortality. (Except for the very smallest hip sizes.) For those with smaller waists, larger hip sizes were strongly associated with reduced mortality. Simple.
The net effect here is that this ratio predicts problematic body shape more accurately than the BMI go the tune of 20% more people are identified as being at risk with Waist/Hip ratios above goal versus BMI above goal. And that correlates with what we see in real life. This becomes the method of choice to determine risk for poor health outcomes and goals for optimal health. It should be one of our vital signs. If only it wasn't so humiliating.
www.What will Work for me? Look at the bright side. We now have a more sure method of monitoring our personal health. All it takes is a measuring tape and you have your work cut out for you. I have worn the same pant size for some 20 years. 38 inches. I must be ok. The horrifying realization came to me when I actually measured myself and realized that I had gotten used to squeezing myself into the same old pant size and then pulling like crazy on the belt. Leave it to your own imagination, but I'm not ideal. I have some personal work to do. Bummer. I just hate data. Especially when there is no one else to blame. I suspect my monthly fast mimicking diet needs to be extended. Join me. Misery loves company.
1. What is now the most accurate health measure to assess your global risk of mortality? Answer: Waist to hip ratio
2. And the desirable ratio should be what for women? Answer: < 0.85 ( 0.9 for men)
3. If you pull on your pants and then have to stretch to get the zipper closed, you might be in what condition? Answer: Cleopatra syndrome. "Queen of De-Nile"
4. Compared to BMI, how many more people are in trouble for excess mortality if their waist to hip ratio is above goal? Answer: 20% more
5. Big hips and skinny waist is horrible for you? T or F? Answer: False. It's good news. You may not be happy with your shape but God Bless You, you are going to live longer than many of us. And you can be happy with that.
NAC and Your Brain
NAC, N-acetyl cysteine, is one of the most studied supplements today. PUBMED registers some 900 citations a year on it. You should know about NAC too because it has a huge benefit on the aging brain. There is some controversy about what its exact mechanism of benefit is, because it has demonstrated so many benefits in so many clinical settings, but the most commonly stated one is that it increases your natural glutathione level. Glutathione is the antioxidant that your body makes to protect itself against oxidation. As we age, we make less.
Our backup antioxidant system in our central nervous system is the vinyl ether bond on plasmalogens, and the loss of glutathione results in scavenging plasmalogen lipids in the brain, leading to a spiral of decline. Folks with cognitive issues have demonstrated less glutathione in their brains. Parkinson's disease is also known to have lower levels of glutathione in the substantial nigra, and IV glutathione has been shown to assist Parkinson's patients to some degree. The Michael Fox Parkinson's website has a nice review of it.
NAC has been around since the 1960s when it was first discovered and introduced for the treatment of acetaminophen (Tylenol) overdoses. It halted liver failure overnight when given within 10 hours of ingestion. Over the years, the use of NAC changed from IV administration in the ICU, to IV in the hospital, to IV in the ER, to oral administration in the ER, to outpatient oral administration, and finally, to release as an over-the-counter supplement. It has a remarkable record of safety. Then, in mid-2021, the FDA got a bee in its bonnet and decided to withdraw it as a safe supplement, despite there being no sign of toxicity. It was a technicality of regulations. "Not a lawful dietary ingredient per the FD&C Act’s drug-exclusion clause because the ingredient was first authorized for investigation as a new drug before it was marketed as a dietary supplement." A legal action by various citizen advocacy groups has brought it back on the market pending review.
What's the normal person to do? Well, we do know that NAC protects you from Tylenol toxicity. That is solid. If you are on Tylenol chronically for pain control, the addition of NAC will likely protect you from liver damage. This is no small deal. Chronic liver damage from acetaminophen is part of the epidemic of liver failure in America. If you take enough NAC, you are completely protected.
We do know it raises your glutathione level, if you are low. It has not been shown to elevate levels above normal glutathione. Folks with normal levels of glutathione don't benefit. That includes anyone under age 20. But as we age, so many of us are low that it probably plays a beneficial role in just about everyone over age 60. It is not super well absorbed orally. Only about 10% of an oral dose gets into you so any dose below 1,200 mg is likely not helpful by much. There are indications that 2 grams (2,000 mg) to 4 grams might be what it takes to help lower homocysteine levels. Homocysteine is a marker of methylation stress and correlates with cognitive decline and myocardial infarction risk. Adding NAC to your armamentarium against homocysteine works. Again, by some calibrated increase in dosing. (One report of 50% reduction of homocysteine).
There is one case report of a Tylenol overdose being given 100 grams of NAC IV instead of 10 grams by medical error. That event resulted in death from the NAC overdosing. 10 grams would have saved her life.
That's where we are. In limbo. The FDA is thinking about it. NAC has a remarkable safety profile aside from one case. We allow Tylenol and Benadryl to be on the market, two markedly more dangerous supplements.
www.What will Work for me. I'm irritated by the FDA. I smell a rat. There is some pharmaceutical company trying to leverage the FDA into making it back into a prescription drug, at great expense, for needless effect. I sent in a letter to the FDA registering my annoyance. I'm taking it every day. If you are over age 60, you likely should be too. We get older because our glutathione starts to disappear. NAC alters that trajectory. Taking plasmalogens gives your brain another tool to capture oxidizing free radicals, but glutathione is a remarkable compound. When I found that I had a gene deletion for making my own glutathione that resulted in many elevated environmental toxins, I took IV glutathione for 6 months and completely repaired my toxicities. That's how powerful glutathione is. That's how beneficial NAC is, by extension. I smell a rat.
1. What is NAC? Answer: The altered form of the amino acid cysteine that is the rate-limiting step to you making your own glutathione. Glutathione is your antioxidant of first resort. When you take NAC, your glutathione rises.
2. NAC has been the cure for what common overdose? Answer: Tylenol, the number one oral overdose in America. No one dies if they get to health care within 10 hours.
3. As we age, what happens to our brains with glutathione? Answer: It drops precipitously.
4. Is that a problem? Answer. Yes, because then our brains depend more on plasmalogens to neutralize oxidizing peroxide radicals, and then we deplete our plasmalogens. That is the engine that drives cognitive decline.
5. NAC is a very dangerous compound and should be carefully regulated. People die from it. T or F? Answer: Yes, one person has died from getting a 10 times IV overdose. Because we only absorb 10% of it when taken orally, that would have required the equivalent of 1 kilogram of oral NAC to be a lethal dose. One kilogram of any drug on the market would be lethal. The right answer is FALSE. It is one of the safest compounds on the market.
This column is written by Dr. John E Whitcomb, MD, Brookfield Longevity, Brookfield, WI. (262-784-5300)
Alkali Therapy for Viral Infections
In 1918 and 1919, during the Great Influenza Pandemic, it was brought to the attention of the US Public Health Service those who naturally took bicarbonate of soda rarely contracted the disease, and if they did, had only mild cases. It wasn't until 1990 that the effect of pH was studied on coronaviruses where it was documented that they were very stable for 24 hours at pH 6 (slightly acidic) but at pH 8, were degraded within 30 minutes. But that is about the sum of the literature out there directly looking at pH and alkali therapy. A hint, from 1919, that bicarb helped people survive an illness in which many were described to succumb within 12 hours to an overwhelming cytokine storm.
Can we paint a picture of what is going on? The clue might come from an exploration of connexins. This is basic human physiology. Every cell in your body, except muscle and red blood cells, have connexin channels. There are 6 proteins in connexins that make a donut shape that links to a similar donut on the cell next to them. That allows the two cells to talk to each other by passing back and forth small molecules that act as signaling agents. There are a raft of molecules that affect many functions of the cell such as cyclic-AMP(cAMP) that are routinely passed back and forth. But our cells also communicate with short chains of messenger RNA through connexin channels. Guess what happens when your cells get stressed? They start running on lactate, become more acidic and connexin channels slam shut.
Bingo, there it is. When you are under physiological stress, your body is frantically trying to mount a defense of the invading organism. COVID virus is known to be extremely efficient at hijacking your energy production to divert it to the manufacture of new lipid coating for new viral particles. The virus has only one action in mind, to replicate and move on. We can't measure the pH inside the cell and we certainly aren't to the point of examing how those connexins work with COVID-19. (Should we now be calling it COVID-22?)
We do know that the human diet has shifted its overall alkali intake from positive 80 meq a day to negative 38 meq. That means from a net alkali diet, to a net acid diet. That's the engine driving our pandemic of osteoporosis. Our blood pH really doesn't change at all in response to alkali-acid intake, but our buffering systems do and our cells and connexins certainly can read that effect.
Hence, we can only offer a hypothesis that is supported by observation but lacking in bench science. Alkali therapy works in viral infections. It increases your cell to cell communication and you end up with a milder form of disease.
www.What will Work for me. For now that has to be good enough. If you get COVID-19, or any other virus, consider taking 2 tablets of Alkaselzer Gold twice a day. That's it. That's all it takes. Some oral bicarb will do too. You can buy Arm and Hammer and take a tablespoon twice a day. That is the same chemical quantity of bicarb we have changed in our paleolithic change of food in the shift to modern food. Potassium citrate will have the same effect. If you are taking that to rebuild your bones, you can probably rest with a slightly smug smile that you are as protected from COVID as you biologically can be, short of turning your immune system on with vaccination or infection.
1. Through most of mammalian history, we had a predominantly alkaline diet? T or F. Answer: True
2. In the Great Flu Pandemic of 1919, folks were observed to not get the flu when they ate what? Answer: Bicarb of soda. (Strongly alkalizing)
3. Every cell in our bodies (except muscles and red cells) talk to each other by what means? Answer: Connexin proteins that make connecting pores.
4. What happens to those pores when you are "acidic" or under stress and filled with lactate? Answer: Connexin pores shut with acid.
5. How much bicarb does it take to make you effectively alkalized? Answer: Two tablets of Alkaselzer Gold, twice a day. Try it. See if it works for you with your next bout of flu or a cold.
This column is written by Dr. John E Whitcomb, MD,Brookfield Longevity, Brookfield, WI. (262-784-5300)
Does COVID Trigger Diabetes - The Chicken or the Egg?
I smell a rat. COVID-19 isn't just a nasty cold. Once you have recovered from your loss of smell or taste, long-term follow-up may show that you have become diabetic. The CDC just published a study showing that for people under age 18, their risk of becoming diabetic is 2.66 fold (Hazard Ratio) greater after COVID infection. Another study published in Cell Metabolism examined 3,700 cases of COVID-19 showed that about half developed high blood glucose when ill with the virus. If intubated, the number was about 90%. Of those who died, fully 77% had high blood glucose. Said differently, high blood glucose increased the risk of intubation 15 fold and death 3.6 fold. Goodness! The relationship of this virus to diabetes is explosive. Which came first, the virus or the diabetes? Do they depend upon each other?
Now, in the Cell Metabolism paper, Dr. Lo, the author, noted that C-peptide, a marker of insulin production was not low. That means folks are still making insulin. It's not like the virus is knocking off beta cells in the pancreas. That is what happens in Type -1 diabetes which is an insulin-dependent disease. So it's not pancreas failure that's happening. What they did find was that patients with high blood glucose were producing extremely low levels of adiponectin. It's fat cell failure!
Adiponectin is made by fat cells and is meant as an instruction to other cells to take up glucose. When you get overweight, your adiponectin drops, and that is part of the dilemma of being obese. You can tell when you have lost enough weight because your adiponectin levels start to rise which correlates with blood sugar getting better. Without adiponectin, your cells aren't talking to each other in the normal fashion. And we now know that the COVID-19 virus attacks fat cells and can replicate in them. The same paper reported that another feature of dysregulated COVID-19 metabolism was the elevation of triglycerides, which we also see in diabetics.
What's going on? Hmmm. It feels like the picture of COVID-19 is beginning to coalesce. Doing quality, randomized-placebo controlled trials in the midst of a pandemic is no mean feat. But we do know the COVID virus is the most aggressive virus at hi-jacking your energy metabolism. Now we have the link showing that fat cells, where energy is meant to be stored also get broken, and stay broken. This long-term effect speaks to some alteration in the fat cells' DNA, but that has not been demonstrated or proven yet. Long-term diabetes takes decades off your life. Renal failure, dialysis, cognitive decline, heart disease all follow.
This wicked virus is not just a cold. It is one of the most dangerous viruses we have to navigate in our lives. Ramping up your immune system early by vaccination is the only sure means by which you can avoid all those complications. The complications of the virus are orders of magnitude more problematic than the vaccine.
www. What will Work for me? The story of glucose metabolism and the management of being overweight is central to longevity. If we want to live a long and healthy life, controlling our weight and blood glucose is key. There is no other virus that has quite the monkey wrench capability of disrupting your ability to metabolize glucose. And no other virus leaves you will long-term disease quite like this. (Some maintain infection: Epstein Barr, Shingles, Herpes, Hep B, Hep C. Those are all prolonged infections.) This long-term complication shifts the summary risk-benefit of vaccination versus native infection dramatically to the vaccination side. "Get the jab". Medical students today will be studying the long-term effects of this deadly virus for their entire careers.
1. Which happens first: the chicken or the egg? Answer: Not to be glib, it is clear that having high glucose puts you at greater risk of COVID. But developing COVID may also push you into diabetes. There is a continuum of risk here.
2. As best we know, pancreas cells in folks with COVID are still producing when hormone that proves their beta cells are still making insulin? Answer: C-peptide
3. What hormone is dramatically lower in folks with COVID who develop high glucose? Answer: Adiponectin.
4. Who else has low levels of adiponectin? Answer; overweight.
5. If I get COVID and develop diabetes, it will get better when I get better from the virus? T or F Answer: Oops! No, sorry. It appears to be a long-term state, once triggered. Could be long-term infection is lurking in fat cells. That's a reasonable hypothesis. Research on the fly is always preliminary and fraught with error. But there it is.
This column is written by Dr. John E Whitcomb, MD, Brookfield Longevity, Brookfield, WI. (262-784-5300)
Is Your Crohn's disease from Your Milk?
There is something rotten about Crohn's Disease. Its prevalence has been steadily increasing in the USA and Great Britain. Since the year 1999, the prevalence has increased from 0.9 % to today at 1.3%. That's close to a 50% increase. That was close to the same increase we saw in 1999 over the prior decades. We keep doing this. That speaks to an environmental cause for the disease. That's Fact #1.
Fact #2. Crohn's is basically a disease of "granulomas", little oval-shaped structures in the wall of the small bowel. Now, that pathological structure is only shared with two other diseases. Tuberculosis. And sarcoidosis. We know tuberculosis in its classical form is an infectious disease caused by Mycobacterium tuberculosis. Could the same thought be applied to Crohn's? Could Crohn's disease in humans be the same as Johne's in dairy? Is it just in dairy? Is there more news about it?
What is Johne's disease? It is the infection of cows with atypical tuberculosis that gradually saps their milk production. It is present in some 1%+ of Wisconsin cows. Its control is still voluntary, though most farmers now know about it. What is reality now is that we collect milk into giant trucks that mix the milk from hundreds of cows, if not several dairies making the infection potentially much more widely dissipated. You don't buy your milk from one farmer, and one cow. Every glass of milk has the product of 200 cows in it. Hmmm.
There is more news. We now know it is not just in cows. Small mammals get it too. Goats and sheep are vulnerable. The University of Wisconsin now has a full-fledged Johne's information center with faculty dedicated to studying it and assisting the dairy industry. The technology of genetic analysis has leaped forward and it is now possible to find the DNA of the mycobacteria avium paratuberculosis (MAP) in manure, just like we are tracking COVID in human sewage systems. That's huge and presents an enormous tool for control and eradication.
This column has covered this topic before, but it has been over 10 years since we reviewed it. I wanted to see if the world of science had come to any conclusions that are more helpful or definitive. There continues to be smoke, and there continues to be speculation, but proof is very elusive. A review article in the World Jr of Gastroenterology details the problems. The waxy wall around the MAP bacteria makes it able to survive pasteurization and many community water purification systems. It is an extremely slow-growing bacteria. That means culturing it is no mean feat and requires a prolonged observation time: on the order of months rather than the two days to find streptococcus.
One might ask the question, can you detect the MAP DNA in human stool? And the answer is YES! It has been studied and guess what the findings show? A stunning 68% of Crohn's patients have the MAP DNA in their stool. 65% of ulcerative colitis patients were positive. Sounds like a slam dunk. Except that 48% of controls were positive. But small numbers (20 and 30 cases in each group). The MAP DNA is certainly there.
Apparently, the MAP bacteria needs iron and can't import it from the outside world. To do so requires making "mycobactin", which is a complex molecule that binds the iron. The MAP bacteria can't do that and depends on passively getting it from elsewhere. That may be the key to its extremely slow growth making its culture growth almost impossible.
But all this news represents a gradual tilt from faint possibility of MAP causing Crohn's to being at the point of almost recognizing it as the cause in at least 50%, and calling for all patients to be assessed for their presence of MAP DNA in their stools. If positive, long-term, low-grade antibiotic treatment may be in order.
That takeaway message for you should be that almost 48% of the population has MAP DNA in their stool. Does that represent 48% of people being affected by the MAP bacteria, just not having Crohn's or UC yet, or does it reflect the incredible sensitivity of DNA technology to find the MAP DNA that came from milk ingestion of contaminated dairy?
Johne's is hard to detect in dairy cows. With diligence, it is possible to find it, but its persistence speaks to the fact that it is still there, and despite a well-known program to address it, it remains there.
www.What will Work for me? I think it's time to test our milk with DNA for the presence of MAP DNA. It's time to make control of MAP mandatory for anyone who supplies dairy for public consumption. Plain and simple. Our dairy otherwise could be considered an existential threat to our safety and wellbeing. Anyone with Crohn's would agree. We can't keep increasing at 50% every 20 years and soon not all have it. And in my book, I now believe we have to consider Crohn's an infectious disease and be open to long-term treatment with antibiotics. Call your representative or senator and ask them to get on board. Send them this email. They know someone with Crohn's. I won't buy animal milk products until I'm assured of their safety.
1. What is Johne's disease? Answer: An infectious disease in animals (cows, sheep, goats....) caused by the atypical mycobacterium avium paratuberculosis. (MAP)
2. Is the MAP bacteria cleared with pasteurizing? Answer: No one can tell you "absolutely".
3. What percent of Crohn's from Italy have MAP DNA in their stool? Answer: about 2/3rds. But asymptomatic folks have a 48% prevalence rate.
4. What has been happening to the prevalence of Crohn's in America? Answer: On the order of doubling every 40 years. Some horrible number.
5. What is the impact of Crohn's on those who have it? Answer: Just awful. You don't want this disease.
The column was written by John E Whitcomb, MD, Brookfield Longevity, Brookfield, WI.
Our Diet Has Become Acidic
Mountain gorillas have a urinary pH of 8.5. They are almost exclusively vegan. Chimpanzees will eat meat, and their urinary pH ranges from 5.5 to 9.0, depending on whether they have recently eaten a captured animal. If vegan, pH 8.5-9.0 and if eating meat, 5.5. You will have the same effect and you can do the test yourself. Eat a vegan diet for a week and measure your urinary pH. It will be above 8. The biological "ash" of plants is a bit of alkaline salts. The biological ash of animals foods is some acid. (No animal products, no grains, no cheese or dairy, no sugar. Raw.).
Go back to eating a standard American diet, where you get 37% of your calories from animals, and your urine will become pH 5.5, acidic. That's because animal-based foods tend to have about 3 times the Net Acid production that plants have as alkali. Simplified that means you have to eat three servings of plant to neutralize the acid of on serving of animal (cheese is even more acidic: its ratio is 6 to 1). Grains are about balanced with acid against vegetables, so it only takes one serving of vegetables to balance the acid of a slice of bread.
The question arises about what happened to humans as we transitioned from hunter-gatherers to sedentary, urban dwellers watching football and playing computer games while eating nachos, cheese, and pizza? As hunter-gatherers, we certainly ate some animal products. That was the object of our hunting. We also always had plants as our backup staple in case the hunting failed. The Hazda of Tanzania are instructive. They are constantly hunting for animals, but not always successfully. Their women know some 250 plants which they gather and bring home to consume in case the men don't capture an animal. Their pH will bounce back and forth from alkaline to acidic, based on the success of their hunt and the volume of their plant consumption.
Applying the best computer algorithms to measure the net acid excretion of diets, Sebastian looked at the diets of 159 preagricultural societies and estimated that their diets were mostly plant-based to the tune of a Positive alkaline load of 84 meq of alkali. The same formulas applied to modern, advanced societies' diets calculate that we are about 48 meq of acid. That suggested about a 132 meq shift from alkaline to acidic.
A second way to look at it is to estimate the Plant to Animal ratio in diets as societies navigate food choices, economic wealth, trade, and distribution of foods and modern food production. Again, Sebastian's team estimated a Plant to Animal ratio from 85:15 in hunter-gatherer, pre-modern societies to 5:95 with a net acid shift from -178 (very alkaline) to + 181 (very acidic). Overall, about 50% of hunter-gatherers were able to get enough animal product to be net acidic, so they weren't all always alkaline. (Think the Inuit who lived almost exclusively on animal fat.) It all depended on the environment and the abundance of animal food resources.
All of this data reflects a net shift from alkaline to acid in just a few thousand years. That's not enough time for our DNA to craft new strategies to optimize our biochemical response.
What are the implications for humans living in the 21st century? What happens when we get a net acid load in our bodies? This is quite a profound shift, particularly because most of our physiology from 64 million years of mammalian evolution was crafted in an alkaline environment. We are pushing our metabolism to the edge of what it can handle. The pH of your blood is an incredibly important constant and our multiple buffer systems speak to that. Our pH doesn't change enough to measure. Our buffer systems do change but they are so myriad and so fluid that our current measurement systems can't catch it. We can only measure the net balance of what comes out in our urine.
A first consideration is in our bones. We now have unequivocal proof that alkalizing your urine by taking potassium citrate will repair the epidemic of osteoporosis. Most studies have used 60 meq of potassium citrate a day, which alkalizes urine sufficiently to increase bone density within a year in every study published. That's an easy one to recognize.
It goes further. Basic to every organ are "connexins", or pores, that allow cells to communicate to the cell adjacent to it. Connexins are exquisitely sensitive to pH. There is now increasing interest in how connexin dysfunction plays a role in obesity. But those little pores are shut tight if you are acidic. Fascinating.
There is beginning to be academic interest in the "alkaline" diet as a way of helping chemotherapy in cancer, renal disease, and multiple other conditions. Just as an example, we now know that more vegetables help lower blood pressure.
The world of naturopathic medicine is all over this concept and many practitioners offer dark-field examination of blood. With an alkaline diet, red cells will stand apart and show a halo around them. As soon as a person ingests an acidic load, that halo disappears and red cells make stacks of cells in rouleaux formation. My suspicion is that naturopaths, locked out of the hallways of medicine, have had to innovate and explore heretofore unexplored ideas. They may be on to something.
www.What will Work for me? Every health condition you can name gets better with "more vegetables". Daniel figured that out in the first randomized, placebo-controlled trial in history. (Just read the first chapter of the Book of Daniel.). Daniel and his fellow Jews ate vegetables instead of the king's rich food and in a short time, looked much healthier. They didn't have MRIs or Chem panels to show the difference, just their own common sense.) I have also personally seen acidic blood with rouleaux formation change in 20 minutes in three people when they ingested an alkaline smoothie. We were designed to be mostly alkaline. In short, more vegetables. Eat up. Measure your urinary pH. We now have pretty good evidence to show the alkaline to acid shift in the last 5,000 years and we are suffering from the consequences. If I were in an academic setting, this would be my field of study.
(Editors Note: We have done this topic some 8 years ago or so. The new material is the quantitative measurements. The good news is that more academic centers are taking it up and considering its implications. And there are critics who suggest we haven't shifted at all.....and critiques of their sloppy work. )
1. A healthy urine pH of 8 reflects what? Answer: a diet with more vegetable material, not including grains, than animal.
2. What was the ratio of servings of animal to plant to grain? Answer: 3:11 with a 6 for cheese.
3. Calculate for me the number of servings of vegetables you have to eat to neutralize the acid of a Big Mac? (3 breads, 2 animal, 2 cheese). Answer: 21
4. I can cure osteoporosis? Really? You must be kidding? Answer: Yes, yes and no. The literature is clear and concise. You don't need to spend $ 10,000 a year and myriad side effects. Yes, you still need Vit D, K2, magnesium, and fish oil.
5. What are connexins? Answer: pores that open up between cells to communicate across cellular membranes. Very sensitive to acid/alkali load.
This column was written by Dr. John E Whitcomb, MD, Brookfield Longevity, Brookfield, WI
Does Your Plumbing and Your Vitamin Pill Cause Alzheimer's?
In America, 30% of folks show cognitive decline in their 80s. Did you know that in rural India the incidence is 1.07% for those over age 65? In Nigeria, the rate is 0.52% for those aged 75-84. That's fact 1.
Fact 2 is that Alzheimer's is a recent disease. It was not described prior to World War 2 despite there being multiple, reputable, rigorous reviews of brain pathology. For example, William Osler, the founder of Johns Hopkins, the originator of residency specialty training, the author of the first textbook of medicine, did not describe Alzheimer's. Freud didn't describe it. Boyd, a famous brain pathologist who published a textbook of brain pathology as late as 1938 didn't describe it. And there were plenty of old folks who should have been sufficient to have the disease noticed prior to World War II.
What is your conclusion from these two facts? Alzheimer's is a new disease, not a given of human biology. And it happens in some, but not all advanced societies. We are doing this to ourselves. What are we doing? Read on.
What happened in World War II? We developed a massive copper industry to fuel the manufacturing of bullets and shells. Copper was so cheap after WWII that houses had their roofs sheathed in copper sheeting. The industry was desperate to stay alive, and thus it innovated and made copper tubing. Pipes for homes. In just a decade, the entire home building industry shifted from iron pipes to copper pipes. Your home likely has copper plumbing.
A home with copper pipes will shed about 0.1 ppm of divalent copper. Cu-2. The EPA claims that 1.3 ppm is safe. That is a 10-fold margin of safety. But is it safe? A famous study of rabbits showed that pure drinking water results in no amyloid plaque in the rabbits’ brains. But add in .1 ppm Cu-2 and bingo, plaque and memory problems. So, no, 0.1 ppm of Cu-2 is not safe.
The problem comes down to some simple chemistry. There is a huge difference between the copper in your body, Cu-1 (chemically +1) versus what comes off the pipe in your home, Cu-2 (chemically +2). In mammalian intestines, there is a Cu-1 receptor. Biological copper is always, always, Cu-1. Period. That copper is absorbed and carefully processed in the liver. There is no Cu-2 receptor. That copper does not exist in normal biological systems. That copper goes directly into your blood and causes all sorts of havoc. It is unregulated by your biological control systems. You can prove all that by using radioactive Cu-1 or Cu-2 and see where it goes. It's easy to prove. Cu-2 shows up immediately in your blood. Cu-1 takes days to show up, and is then bound to carrier proteins.
Copper is an incredibly important trace mineral. It is extremely bioactive. It plays a pivotal role in protecting our bodies from redox reactions, helping neutralize peroxide made from escaped electrons in the mitochondrial electron transport chain. It is so bioactive that it's management is tightly regulated. And that regulation depends on you ingesting Copper-1. Not copper-2. That's it. That's the problem. In a study of 280 random homes in America, 30% of the homes had Cu-2 levels above 0.1 ppm, the level that causes damage in animals.
The Japanese have a low rate of Alzheimer's. Only 6.7%. After WWII, they were offered copper pipes to rebuild all their bombed-out homes. They politely declined, claiming it had not been studied. They use iron pipes. 6.7% versus 30%. Hmmm. What do you read from that?
We now know the precise site of trouble. Amyloid precursor protein tries to get rid of Cu-2 and reduce it down to Cu-1. It does that. But it makes a free oxygen radical is so doing. That goes out and causes damage. And it makes Beta-amyloid accumulate. Throw in diabetes and too much glucose, and you get glycation. Add Cu-2 with glycation and it just explodes with more free radicals and beta-amyloid formation. That's the diabetes, Alzheimer's link with copper.
With the explosion of free radicals, we deplete our plasmalogens. Our synapses start disappearing because we can't protect ourselves from the oxidizing damage of Cu-2. And we use up our plasmalogens at our peril.
The good news is that we can fix all this. What a mess we have made of our biochemistry.
www.What will Work for me. Every home in America from 1950-2010 was built with copper pipes. My 1978 home has copper pipes. Every vitamin pill and mineral supplement has Cu-2 in it. I am taking poison what I take a routine vitamin pill and drink it down with tap water. And that is something I can do something about. I now understand the chemistry right down to the molecules on the membranes of my cells. In my brain, Cu-2 is poison. It never existed in human history in our ecosystem until we made copper pipes and devised copper-containing supplements. I will be reading every supplement I ever take hereafter. And I will be measuring my copper and zinc levels twice a year. I am so happy I bought a RO water system from my drinking water. And to demonstrate my OCD, I even now distill my own water. It's cheaper than buying it from the grocery store.
1. Copper is a necessary trace mineral. What form does it exist in nature? Answer: It's called copper-1 and has a +1 electrical charge.
2. What copper ion comes out of our copper pipes? Answer: Copper-2 that has a +2 charge.
3. What level of Cu-2 is safe according to the EPA? Answer: 1.3 ppm
4. What level of Cu-2 comes out of 30% of American homes' pipes? Answer: Higher than 0.1
5. What happens to animals when they ingest 0.1 ppm Cu-2? Answer: they get amyloid plaques and memory problems. Just like humans
6. In natural systems, there are biological proteins to carry copper. What type of copper can they absorb? Answer: Cu-1 only. No impact on Cu-2
7. How often should we check our Zinc-Copper levels? Twice a year. And please, please, please examine your vitamin pills and stop taking any that have copper in them. Vitamin pills always have Cu-2 only.
8. What form of copper is in your vitamin pill? Answer: Cu-2. Oops. Poison.
This column was written by Dr John E Whitcomb, MD, Brookfield Longevity, Brookfield WI.
"Benign" Incidental Tumors on Adrenal Glands are Common
This is a hugely important study that may go a very long way to explaining puzzling conundrums in menopausal women. Most notably, "Why can't I lose weight?" or "Why do I have high blood pressure suddenly out of the blue?". You may have never heard of an "adrenal incidentalomas" but it is what its name sounds like: an incidental nodule or "mass" on the adrenal gland, found, by chance with a CT or MRI of the abdomen that includes the adrenal glands. As CT and MRI scanning has become more widespread, more of these incidental adenomas (lumps) have been found. A surprising number of them (2/3rds) appear to be in post-menopausal women.
It's the link to MACS (Mild Autonomous Cortisol Secretion) that was the impetus to this study. Cushing's Disease is most commonly caused by a "benign" tumor that excretes unregulated cortisol. Those folks show a classic picture of high blood pressure, weight gain, stretch marks, buffalo humps on their backs, and muscle weakness: all effects of too much cortisol. The question to be answered was whether there is a continuum of this archetype disease to a milder form, MACS, associated with these incidental "swellings" that hadn't become a defined mass or tumor.
They found 1305 of incidentaloma patients and evaluated them for MACS and sure enough, there was a very strong association between the tumors and the cortisol, particularly if the women had resistant diabetes needing insulin and high blood pressure needing extra medications.
In fact, the numbers were striking. In Great Britain alone, the results of this study suggested that some 1.3 million women might be affected. This becomes one of the first considerations to review if post-menopausal women have high blood pressure and diabetes. Added to their evaluation should now be a screening for MACS which essentially comes down to collecting a 24 hour urine for adrenal steroids. So, it is a continuum with Cushing's. There is a milder form. And the "milder" form may not be so benign or mild.
What has yet to be determined is whether these women all need CT/MRI's of their adrenal glands. We need clear guidelines as to what are acceptable limits of cortisol production on 24 hour urine tests. A lot of health care system training is in order.
Cushing’s disease gets severe osteoporosis. Does MACS? Yes! Do we need to checkevery woman with osteoporosis? That same thread is going to now arise with diabetes, high blood pressure, sarcopenia, weight gain.......on and on. This is a seismic shift. Huge advance. Good work, team!
WWW.What will work for me? It's not often that a major shift in disease management comes along. This is one. My ears are burning with memories of women who I have seen who have asked the question, "Might I have Cushing's?" and on standard testing, they fell through the cracks. Now we have new criteria and a new "syndrome", a complex of tests to explain. Once again, the "patient" was right. Fortunately, someone in Great Britain paid attention. It just has to be part of our workup in standard internal medicine.
1. MACS stands for what? Answer: Mild autonomous cortisol secretion.
2. Where is it found? Answer: For now, it is found in post-menopausal women who have high blood pressure and or diabetes which are slightly treatment-resistant.
3. How common is this? Answer: In women in Great Britain, the guestimate is 1.3 million women (2% at age 50 rising to 10% at age 70). That would translate into 8 million + women in the USA. A lot.
4. What are other symptoms that might be part of the syndrome? (Think what symptoms go along with Cushing's disease?). Answer: Osteoporosis, stubborn obesity particularly in the core body, sarcopenia, besides the resistant high glucose and blood pressure.
5. How do we diagnose MACS? Answer: A one-time cortisol won't define it. We will have to get 24-hour urine collections to see the totality of cortisol production, and then be more open to further testing with more nuanced parameters for the rest of the testing.
6. What's the treatment? Answer: Surgery to remove it? Yet to be determined. We don't know what is the chicken and what is the egg. What caused it? Can that be reversed? Are their effective, non-toxic drugs? Will lifestyle changes work?
Written by Dr. John Whitcomb, MD at Brookfield Longevity, Brookfield, Wisconsin
COVID Metabolomics Finds Monolaurin as a Predictor of Mortality
We have referenced this before, metabolomics, and here it is again around COVID. It becomes more important to understand. With Omicron surging at 5-7 times infectivity rate, you may want to pay attention to this idea.
What is metabolomics? It is the study of everything in your "metabolome", or everything that your genes make in your blood. Your genome is the genes you have inherited. Your metabolome is the result of those genes in the environment you are living. When you activate genes, your DNA makes messenger RNA to manufacture new proteins. That you know. Your messenger RNA gets sent out all over your body in exosomes and to adjacent cells via pores so that individual cells communicate with their near neighbors and with distant cells. That makes for a coordinated, system-wide response to environmental challenges.
This method of science is actually a reversal of the usual method for studying disease. Instead of looking at COVID patients the old-fashioned way, trying one treatment after another based on prior experience, metabolomics looks at many patients with COVID and measures everything in their blood. Everything. Like the human genome project that measures every gene, and then looks at what genes are associated with what illnesses, metabolomics looks at every molecule made and present in the blood that represent a successful response to any given illness.
In this case, the illness being examined was COVID. In Italy, 51 health care workers at high risk for getting COVID had their blood examined by this method. As reported in Nature Magazine, health care workers are at high risk for developing COVID. They are real heroes. And in fact, of the 51, half-developed COVID within the month. This was at the beginning of the pandemic, prior to adequate PPE when everyone was scrambling, trying to discover just what it was that put folks at risk, and how to properly protect our precious health care workers.
Metabolomics is not an easy or inexpensive method. You aren't performing a "Chem 12", the standard blood test looking at traditional risk measures. A metabolomics test is essentially a "Chem 25,000", measuring everything in the blood. That takes huge computing power, and more importantly, it takes a lot of exploration to figure out what all those compounds are in the blood. This is the same process Goodenowe did in his cohort from Rush-Presbyterian with aging Catholic clergy. That takes time. The investigators found 322 "small molecules" that they went to work on to see what was helpful. (This did not look at much larger proteins, antibodies, and other complex compounds.)
But what popped out was monolaurin. Monolaurin is basically a product of coconut oil. It is known for having antiviral effects, but even WEB MD states that it "needs further study". Monolaurin blood levels were highly correlated in these health care workers with not getting sick from COVID. It is known to "dissolve" the viral membrane of viruses very effectively. N,N dimethylglycine, an amino acid, also popped out. Finally, higher levels of cholesterol appeared as a risk factor. This correlates with statins that also appear to be partially protective against COVID.
This study is the first to show the scientific process of metabolomics on COVID. It adds to a recent report in MedRxIV from Englandfollowing some 327,000 folks that people taking probiotics, Vitamin D, fish oil and multivitamins, did better against COVID. Now we can add monolaurin or just straight-up coconut oil. In fact, the authors suggest that the use of topical coconut oil may also confer some benefit.
www.What will Work for me? With the looming threat of a third wave of COVID, we are all a bit off balance. I am. I'm vaccinated three times and I wear a mask everywhere I go. But adding coconut oil to my regular cooking is pretty easy. I can order monolaurin as a supplement, and in fact, just did. I can take one more pill for a couple of months without choking to death from too many pills. I do have a small nostalgic moment for my childhood in India where, in my teenage desire to look cool like Americans, I greased my hair with coconut oil. Made my glasses fall down as is melted down behind my ears. I have no photos from the 60s with my glasses up. But at least my hair looked like Elvis...well, vaguely.
1. What is monolaurin? Answer: part of coconut oil. It is basically a 12 carbon fatty acid attached to glycerol. Humans store energy as 16 carbon fatty acids. It's in the medium chain fatty acid family, which may explain why it "dissolves" viral coat membranes.
2. What is my metabolome? Answer: the sum of all the products your body makes that is floating around in your blood outside of your cells.
3. How can you test it? Answer: If you read the paper in Nature, they took a mass spectrometer to find every product they could in 51 health care workers and ended up with 322 "small particles". It would have taken far longer to explore larger proteins, peptides, and hormones. But is there a blood test for monolaurin? No.
4. What else was associated with better survival with COVID? Answer: N,N dimethyl glycine, an amino acid and lower cholesterol. (Those topics will have to wait for another day.)
5. Are there other supplements proven by population studies you can take that help COVID survival? Answer: Yes. A review of 327,000+ British folks showed that Vitamin D, probiotics, omega-3 fats, and multivitamins all were associated with better survival. Sounds like a pretty good handbook.