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HR, please comment. PPC-Thyroid
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HR, please comment. PPC-Thyroid

after researching PPC i see that it is a Soy product. there has been some negative things said about Soy and its effect on the thyroid. since HCV can affect the thyroid would adding Soy further damage it? thanks
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Avatar_dr_m_tn
PPC preparations from soy should normally be suficiently pure, so as to not carry any of the soy isoflavones with it. Thus there are no general " soy' considerations to be taken into account, with the exception of allergies, since trace amounts of the non PPC soy ingredients will always be present.
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Avatar_dr_m_tn
All of these questions  of course open up a huge line of practical and theoretical considerations, way too complex to cover in these limited circumstances:

So the the "negative impact" of soy  - presumably isoflavones - on thyroid function is one of these topics ;

Soy foods are a traditional staple of Asian diets but because of their purported health benefits they have become popular in recent years among non-Asians, especially postmenopausal women. There are many bioactive soybean components that may contribute to the hypothesized health benefits of soy but

most attention has focused on the isoflavones, which have both hormonal and nonhormonal properties.

However, despite the possible benefits concerns have been expressed that soy may be contraindicated for some subsets of the population. One concern is that soy may adversely affect thyroid function and interfere with the absorption of synthetic thyroid hormone. Thus, the purpose of this review is to evaluate the relevant literature and provide the clinician guidance for advising their patients about the effects of soy on thyroid function. In total, 14 trials (thyroid function was not the primary health outcome in any trial) were identified in which the effects of soy foods or isoflavones on at least one measure of thyroid function was assessed in presumably healthy subjects; eight involved women only, four involved men, and two both men and women.

With only one exception, either no effects or only very modest changes were noted in these trials.

Thus, collectively the findings provide little evidence that in euthyroid, iodine-replete individuals, soy foods, or isoflavones adversely affect thyroid function.

In contrast, some evidence suggests that soy foods, by inhibiting absorption, may increase the dose of thyroid hormone required by hypothyroid patients. However, hypothyroid adults need not avoid soy foods. In addition, there remains a theoretical concern based on in vitro and animal data that in individuals with compromised thyroid function and/or whose iodine intake is marginal soy foods may increase risk of developing clinical hypothyroidism. Therefore, it is important for soy food consumers to make sure their intake of iodine is adequate.

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Avatar_dr_m_tn
Sorry, I should have placed the lower portion of the previous post  into quotes, since it is a quotation from a review, that I structured a little to make it more transparent.
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Avatar_m_tn
I wonder if these Hawiian studies have been followed up on? I know they gave me slight pause when I started adding more soy to my diet.

"The study suggested a strong
link between (soy)
and faster aging

http://starbulletin.com/2000/04/03/news/story1.html
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Avatar_m_tn
Thanks for the reply. i just received the hepatopro supplement and good to know it will not affect the thyroid. if someone is "hyper" not "hypo" could soy product possible help them?

also could you tell me what the ALA & TMG is in the list you provided in an earlier thread. thanks again

PPC/NAC/ALA/TMG/SAme/Silymarin/Catechin/Resvera/(Curcumin?)
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Avatar_dr_m_tn
ALA = alpha lipoic acid= Thioctic acid = Lipoic acid= Liponsaeure. Do not use Dihydrolipoic acid, as it is very hard on the stomach, otherwise it would be better.

TMG= trimethylglycin= betaine=         DMG(dimethylglycin)+1methylgroup  
A methyldonor as required for many synthetic reactions in the liver.

If somebody is hyperthyreoid, he will need a good endocrinologist, not play around with self supplement treatment. Hyperthyreodism is typically an autoimmune disorder, with antithyroid autoantibodies reacting with the thyroid TSH receptor as if they were mimicking TSH, leading to uncontrolled, runaway activation....
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233616_tn?1312790796
just a couple simple remark here, if PPC could help the liver I'd rather keep an eye on cholesterol and also adjust my throid dose as nessessary since I am hypo and since thyroid meds are and that's better than losing one's liver..

Hyper and hypo are both dangerous, even life threatening without treatment so the blood monitoring is important even though some docs understate the dangers to their patients, seriously understate.

HR's mention of iodine is noteworthy, particularly as it relates to hypo I have some small knowledge. One absolutely needs treatment and monitoring for these disease...and it all depends on why the thyroid is shutting down as to whether what's below will aide you;

because mine was diagnosed as not autoimmune but plainhypo to begin with,
my method was to use a daily capsule of kelp powder (not tablets not much in those) to keep iodine and trace mineral supply up. This method actually returned my thyroid to normal function according to testing for many years, and should not be underestimated for it's preventative benefits.
However, a deficiency is somewhat different than what can cause autoimmune....and of course now they say HCV can be a contributor to all autoimmune stuff......not all autoimmune is strictly definciency related though. Some is genetic, mine was radioactive as well as HCV, myriad causes exist for what triggers and sustains autoimmune response.

This therapy though, the kelp,  did help me, but only worked because part of my equation was having "Northwest hypothyroidism" (local diet in iodine poor soil produces the most cases nationwide due to lack of dietary iodine). However, many locals, and many diets in the states are especially low in iodine, hence hypothyroidism (low) is the most common of the thyroid ailments.
At one time, this was such a health problem here in Oregon that it was made the LAW they add iodine to all the salt,  as this was the easist way to cure all the people. (Everyone uses salt in foods and cooking).....but alas, the health nuts (who didn't do their homework) pissed and moaned and made them remove the iodine claiming the state was trying to poison them and remove their rights. (yeah, the right to be unnessessarily sick)....anyway.... Many people are low on this mineral, more now than ever. Personally, I think the addition of iodine vs. a whole other medication regime was wisdom.

Not sure for the non allergic that the small amount of soy would be problematic
would it HR?
Considering there's so many other sources of soy everyday many don't even know they get...
like in hydrolized protein, corn chips, you name it, unless one has a known soy allergy it hardly seems this small of an amount would present a problem.
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Avatar_f_tn
Seems a bit of a toss-up.  My thyroid died after mistakenly being killed by interferon ( didn't work on the HCV, though).  I do eat a lot of soy, although I have heard that there could possibly be thyroid and other isues with it.  I eat it because (I like it and) I don't eat meat.  I don't NOT eat meat because of health reasons, but  I think that I've read that red meat can be pretty taxing on the liver.  So maybe it balances out?
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Avatar_m_tn
if i had to pick one to keep it would be the liver. can live without the thyroid but not the liver :-)
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Avatar_f_tn
Copyman- yeah that's true!

HR  I've ordered and gotten the alpha-lipoic acid, reservatol and TMG.  Waited till the weekend to start them. Looking up TMG, though, I see that it helps the body to produce SAM-E.  I already take a lot (800 mgs) of SAM-E a day for depression and I wonder if  the TMG will be safe.  Think I'll wait on that until I hear from someone who knows the answer.  Thanks so much for letting us know about these.  S.



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Avatar_dr_m_tn
TMG has been used in very large doses in trials and found to be extremely safe. It is correct, that somebody, that already takes a large dose of SAMe, has less of a need for a methyldonor ( thats what TMG is, for numerous synthetic reactions in the liver).

I metioned TMg before SAme, because it is much cheaper than SAMe and wil produce SAMe naturally in your liver - but maybe not in the high dose range as you take your SAMe. Also needs some folic aid, B12 and B6 to achieve this.
There is no problem in adding the TMG to the SAMe, like in 2x500mg doses, it might still add to the liver protective effects.
It is very important to understand, that these are not stand alone measures. They focus on certain aspects ( like TMG for Methyl groups requiring reactions), but it is difficult to estimate the relative benefits that they will have.

Therefore always this is the hirarchy ( organized by priority) of the approach:

Eating patterns - liver metabolic stress reduction. Many small meals each with fiber embedded slow resorption carbs+30% lean protein+ only healthy fats/oils


Intrestinal health- eubiosis - Glutamine(integrity of intestinal epithelium),prebiotic ( Inulin, Lactulose), Probiotic ( Lactobacillus GG)

Supplements - :
Supporting specific aspects of liver metabolic burden - like TMg, SAMe

Thiol containing compounds: NAC (always with equal mg Vit C),, ALA, Taurine : Build fundamental hepatic/bodywide Glutathione reserve, protect from ox stress toxicities ( like Tylenol)
They also help to block the ox stress dependent stellate cell(fibrogenesis) activation pathways.
Many more functions of course not mentioned here.

PPC: membrane fluidity and functionality


Inhibiting the activation of stellate cells into fiber producing myofibroblasts:

Resveratrol: inhibits with high efficacy  Tumor Growth factor beta - the key player in the activation of fibrogenesis in the liver ( is key activator of improper "wound healing", scar formation (fostering the production of collagen fibvers from transformed stallate cells) inside a parenchymal organ- the liver)

Curcumin : Most effective in blocking the activation of NFKappaB, a nuclear activator of proinflammatory gene expression and also extremely involved in the formation of fiber forming cells in the liver from stellate cells)

Green tea extracts : Same as Curcumin, with less NFKB deactivating capacity, but likely other
complex antiinflammatory benefits.


Overall several key pathways leading to activation of fibrosis will be blocked/reduced in their activity, which will build to a synergistic effect over time. Each of these individual  measures has decent research backup, while all are considered GRAS, but no direct comparison has ever been made so it is hard to estimate the relative contribution.


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233616_tn?1312790796
I'm glad you posted all this again, as I missed large chuck of info being only diagnosed in June and slow on the uptake, pretty sick.

could you post what you think are good doseage amounts for these again.
I think you did this once, but I lost track of that thread.

thanks HR

BTW, doesn't the green tea act as a stimulant having caffiene in it? Would that be one for those NOT currently on Riba so as to not overstimulate an already pretty agitated system?
I'm only asking because the Riba kept me up a lot at first, once for most of 3 days!
mary
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Avatar_dr_m_tn
Yes the green tea should be used as decafffeinated green tea extract.

It is difficult to talk about fix dosages for these supplements, as some have substantial cost and I do not want to encourage anyone to engage in problematic expenses.

Some are cheap. like NAc ( 3x600mg+3x500mg VitC), TMG (3x500mg), Taurine (3x500mg) ALA (3x200mg)

Glutamine approx 1-2gm, Inulin 2-5gm are also cheap. Lactulose is OTC in Canada and rel cheap too.

Probiotics ( like Lactobazillus GG) are difficult to judge, have to be alive, in the fridge and individually packed, hard to test for quality.

But the Polyphenols and like compounds : they are not alike! they have very very individual profiles.
Some are somewhat toxic, like Apigenin and Naringenin. They should not be considered in a class manner, but for their individual potency, research experience behind each of them, known pharmakokinetics/absorption/excretion/toxicity studies.
On the other hand some of those ( resveratrol, curcumin, less so green tea) hold the strongest promise to deliver as antifibrotic blockers of the stellate activation pathway.
Some, like Resveratrol, have worldwide extensive highest quality research behind them.
Some have lifespan studies in animals behind them - those are the most convincing, since hidden toxicities would surface in a reduction of mean lifespan vs controls. Resveratrol prolongs lifespan, of course not tested for that aspect in humans, but has excellent liver protective effects in now famous animal studies. I am still trying to find a quality source for that. Resveratrol should be 98% pure.The pure form is highest priced, so most retailers use the cheaper versions of only 20 or 40% purity from polygonium cuspidatum - not a great idea for long term use ( and the relevant %facts are typically well concealed.)

All supplements and eubiotic measures must always be discussed with your personal hepatologist.If they are not aware of some of these, they might find the time to investigate. This is sometimes hard, since much of this literature has only been presented as posters and abstracts in meetings. But a good hepatologist will attend all the relevant meetings and will study all the many abstracts relevant to fibrosis/organize them for later use  and work his way through the posters.
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Avatar_f_tn
Thanks a lot.  Will be getting some circumon and glutamine, and then will have the full "arsenal'.  Thanks again.  I appreciate you taking the time to explain all of this.  S.
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233616_tn?1312790796
thanks HR for the above synopisis again, I have it on file now.

for all. As to the thoughts on soy and thyroid absorption, the synthetic has to be taken on a empty stomach for full absorption (I take mine a 5 am). All other meds and especially things with Calcium or fat are known to interfere with thyroid med absorption. Therefore it's only logical soy product would as well.

again, to all
makes more sense to treat the liver and monitor/adjust thyroid than not.
Kinda like, blood pressure meds, the may cause some other problems, like potassium loss which is correctable, but the alternative of not taking those meds is stroke and heart attack.
The trade offs need to be weighed carefully before ruling things in or out.
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144210_tn?1273092382
Found a good source for Resveratrol (I think).

http://megaresveratrol.com/
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Avatar_dr_m_tn
That looks indeed as good as it can get, you are right.
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315996_tn?1321809719

wow! what a great thread. glad someone bumped it up to the top where it could be seen.
What if one is not on treatment, and has no liver damage (yet), but is HCV? Would it be advisable to pursue a similar regime? What should be ommited from list if anything? I understand this is all conjecture and hold no one repsonsible for the 10 pounds of supplements I might have to gag on.

Signed,
A Humble Fan

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Avatar_dr_m_tn
Chances are that it might keep your liver on a much lower damage level and fairly free of fibrosis at least. Once the fibroscans will be everywhere, you can then check once a year if this is truly the case. Meanwhile ALT levels should also reflect the positive influence of such a multiregimen. Never forget that the metabolic care and intestinal care come before any supplement. List is the same.
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315996_tn?1321809719

good good good! Thank you!

You really sold me in 2 places over the last month of my frequenting this list:
on Thanksgiving, when you said, "it's best to eat your turkey with just a salad"

and way above where you said:
"Eating patterns - liver metabolic stress reduction. Many small meals each with fiber embedded slow resorption carbs+30% lean protein+ only healthy fats/oils"

What is so important about this is that we can do it now, today.
Once again, thank you.

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315996_tn?1321809719

I'm pretty sure that " fiber embedded slow resorption carbs" means veggies and grains, right?
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Avatar_dr_m_tn
Veggies and salads are the "macrofibers+ microfibers ". They slow everything down, even the basic enzymatic digestion process : macromolecules in food to absorbable monomers of sugar, amino acids and fatty acids. . . Grains - simultaneously with the above therefore, never as a "bolus' as such by themselves ,   grains  should ideally be mainly oatmeal, little to no wheat and always in moderation. Veggies and salads themselves have slow carbs right in  them. What matters is the slow offering of the enterically absorbed "nutrients" to the liver, that has to work them up as they come and therefore can be easily overwhelmed=damaged. if the offerings exceed the available capacity for "nonstressful processing". It is mainly a biochemical processing plant and it can only do so much per minute....Fruits/berries  should also be embedded if possible, since they often . contain relative high available monosugar amounts..It is obvious that any true "sugar" containing drinks or even fruit juices are problematic for all these reasons and "deserts" are not even discussed.....
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233616_tn?1312790796
oatmeal is all I eat morning and noon!! Glas to hear thats OK.

speaking of berries, don't they have very highly bioavailable iron?
Ala, sort of red meat style?
I wish there was a list somewhere of how much is absorbed from each source.
I've got lots of list of what is high in iron, but none on how much can be absorbed from these high sources, which varies according to fiber content and such, right?

anyway, in my "juicing days" berry juice and beet juice were considere very high sources,
so shouldn't they be avoided?  And raisins//prunes/tomatoes, how bout them???
Aren't we supposed to avoid excess iron? I've already cut red meat out completely.

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315996_tn?1321809719

I think when he says "Fruits/berries should also be embedded if possible" he means they are full of sugar and should be mixed in with veggies and salads in smaller amounts. Makes sense to me.

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315996_tn?1321809719

I like the way you say, "be gentle to your liver". I'd tatoo this to my arm except I might get Hepatitis XYZ from the needle.

I was wondering, under this context, about which types of proteins, with regard to protein powder. Reason being it is quickly available in measured quatities. My understanding is that Whey protein is very fast burning not sure about Soy and Hemp and Egg but on the other end my understanding is Cassiene protein powder is the slowest.

Weight lifting crowd reccomends Whey right after a workout because it gets in quick, and they reccommend Casseine at bedtime because it is slower and thus works away and you don't have to get up to drink more.

To summarize: would Casseine be the best protein powder (in a pinch) because it "burns" slower?

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Avatar_dr_m_tn
With re to the protein source it mostly important that it is "lean" ie not coupled with fat, and also that it is " embedded", which will be the best way to slow its workup in the liver. Taking a protein powder is ok if you do embedd it, whey is fine, but some of the sports protein powders  have a lot of carbs in them, so beware. Once hydrolyzed/digested, all protein  becomes a mix of amino acids, which are then absorbed in the samll intestines. Any difference in the absorption rate would be mainly a difference in the speed of digestibility due to the specificity of the digestive proteases.

Some plant proteins do not have a well balanced mix of amino acids as humans need them, with some "essential" aa missing. Complementing with animal protein helps, but the total amount of the missing aa supplied by "complementation" might not be optimal.
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315996_tn?1321809719

Hmm. I see. I do look for the least carbs in protein powder. Also, I am wondering: does the embedding have effect in the stomach or in the overall digestive cycle of the item? In other words, if carbs are absorbed in the stomach and quicker than amino acids from protein would it make sense and eat the protein first and then wait (n amount) until it started working before eating the "embedder"?  Same goes in reverse where the protein slows down the GI of the carbs. Does it slow it down in the mouth/stomach after eating or does the protein only starts it's part way down there in lower land?

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Avatar_dr_m_tn
veggies and salads contain plant cells, that have a lining of cellulose outside their cell membrane, called the cell wall, therefore they do not easily digest - generating a threedimensional  "labyrinth" of physical blockages, where the digestive enzymes have to work their way around them, causing the delay in the production of the sugar and amino acid monomers. The available carbs from the veggies themselves  are inside these cells, so they are also substantially delayed.
Protein digestion starts in the stomach, major carbohydrate digestion ( with the exception of salival amylase) starts in the small intestines, where the exocrine pancreas delivers the bulk of the digestive enzymes for  proteins, carbs and fats through a common outlet with the bile duct into the duodenum. The small intestines themselves (secreting eg approx 4 liters of digestive fluids/day)  contribute the final enzymes needed to finish the breakdown process to respective monomers. Then the absorption process can start and most all of the material goes directly to the liver.
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315996_tn?1321809719

thank you, I think that means I can continue to "embed" at the same time.

Have a great weekend!!

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Avatar_m_tn
The more I read about diets, the more contradictions I find. The more I become confused.

In the diet you seem to describe -- similar to Barry Sear's Zone Diet -- I still can't find where all the calories are coming from if meat is to be low fat and rationed and carbs are to be complex and healthy oils to be limited.

How does a male with  get 2000 calories a day in this manner which I find necessary to hold lean mass?

he conclusion I've come from is that all these Zone type of diets -- 30-30-40 - are they are actuality undercounting fat, so  in fact they are  high fat diets if all fat was counted?

As I mentioned in an earlier post, this argument was made by I believe  Dr. Dean Ornish (or perhaps McDougald) -- both advocates of a high carb, low protein, low fat diet -- against the Zone diet by Barry Sears. Not only that, it is somewhat backed by conversations I had at the very beginning of the Zone diet with Dr. Sear's brother, who actually answered the "diet hot line" phone number in his original book! Whenever asked what to do "if hungry", etc, etc -- his answer was always to "add more fat" and indeed he suggested that many athletes following his diet had an enormous pre cent of their diet fat so both to keep the carb/protein ration in check and not lose lean mass. I don't think this could be very healthy for the HCV liver?

What I also found prior to SVR was that my enzymes were the very lowest on a low protein, very low fat and very high complex carb diet, i.e. the Pritikin diet.

They were the highest on the Zone diet.  My thought was that the main difference was the much higher fat and protein intake of the Zone type of diet you seem to advocate as opposed to a much lower fat and protein diet.

With the Zone, someone my weight was required around 12 ounces of lean animal  protein per day. With the Pritkin diet it was closer to 3 ounces a day and closer to 3-4 ounces a week on the regression diet. And then the difference between a diet of less than 10% of calories (Pritkin) and something like the Zone which could be anywhere from 30-60% fat (or more) depending on how you played around with what Sears consideres the "neutral" component of econosioid? production, the fat portion.

-- Jim

-- Jim
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Avatar_m_tn
This is the essence of the "McDougal Vs Sears (High vs Low Protein) diet:

http://www.drmcdougall.com/med_hot_protein_diets.html

I saw the entire transcript on the web once for free and I'll post if I can find it again.
--------------
The Great Debate
     
           
   High Vs. Low Protein Diets

People all across this country are asking, "Should I be on a high-protein or a low-protein diet to lose weight?"  Experts, many of them with credentials, will encourage you in both directions.  Right now the high-protein message appears to be winning out among the masses.  The best selling diet books on the market--Enter the Zone by Barry Sears, Protein Power by Michael and Mary Eades, Dr. Atkins' New Diet Revolution by Robert Atkins, and Healthy for Life by Richard and Rachael Heller--are all high-protein, low-carbohydrate.  At health shows I find these authors swarmed by followers; even in the face of all the well-publicized scientific evidence that says these diets provide only short-term weight loss, and they are made up of foods known to cause serious diseases.

Why the Popularity?

Many people are desperate to lose weight (and some to become healthier).  Their pleas for help have gone unanswered for one reason or another.  Therefore, any new chance for help is welcome, especially if it requires little effort.  The foods recommended in high-protein diets are the very same rich foods we were all raised with and learned to love in America. They are the juicy roasts, salty hams, braised lamb chops, lobsters drawn in butter, pungent cheeses, salty fried eggs, and crispy bacon.  Foods most people still considered their birthright to enjoy--being born into the wealthiest nation on earth.  Tastes are hard to change.   Preach what people want to hear and you have an immediate following, because naturally we all like to hear good news about our bad habits.

These high-protein diets are often sold to the public with the claim that there is something unique, even mystical, about the effects of protein on the body that makes all well established dietary advise obsolete.  For example, the author of the Enter the Zone claims the problem with our weight and health, specifically heart disease, is that high carbohydrate diets promote excessive production of specific hormones--insulin and "bad" eicosanoids.  The secret to weight loss and preventing heart disease is controlling hormones into a narrow range referred to as "the Zone," by adding more protein to the diet than is commonly consumed or recommended (30% vs 12%).  People love to hear there is a gimmick, like "entering the Zone," that will somehow trick their body into losing extra fat without having to give up the foods they love, or even worse, exercise.  They're also happy to hear it's not their fault they're fat, "It's my hormones that are the real culprit, I don't have to feel guilty about being a glutton and not exercising."
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High-protein diet gurus are usually establishment bashers, they claim they have the truth and all the other doctors, dietitians, and scientists are wrong.  People love to hear the experts are wrong again.  Even better, they like to believe there's a conspiracy by all these establishment professionals to keep them fat and sick.

One of the most important reasons for the popularity of high protein diets is they work--people lose lots of weight fast--but it's mostly water.  Stored carbohydrate contains large amounts of water.  Switching to a low-carbohydrate diet results in the loss of these stores and the associated water, with an impressive initial weight loss.  In addition, if the diet is low enough in carbohydrate, like the Atkins diet, then the body goes into ketosis, causing suppression of the appetite, thereby you eat and suffer less.  I call these "the make yourself sick diets," because they simulate metabolic changes that take place during illness--ketosis is a natural state that occurs when people are sick--a time when they shouldn't be gathering and preparing food, but rather recuperating.

Sickening Foods

The foods recommended for a high protein diet are mainly meat, egg, and dairy products, which are high in cholesterol, fat, and animal protein; and deficient in dietary fiber, carbohydrate; and are often highly contaminated with chemicals and microbes; and  have serious vitamin and mineral imbalances.

"Nutrition and Health in the United States," published under the direction of Surgeon General C. Everett Koop MD in 1988 put to rest all controversy concerning whether or not diet is fundamental in the cause, prevention, and treatment of common diseases.  "The Report's main conclusion is that overconsumption of certain dietary components is now a major concern for Americans.  While many foods are involved, chief among them is the disproportionate consumption of foods high in fats, often at the expense of foods high in complex carbohydrates and fiber that may be more conducive to health."  Similar recommendations to eat fewer animal products and more plants foods have been made by every other health organization, including the Senate Select Committee on Nutrition, American Heart Association, the American Cancer Society, The Diabetic Association, and the American Dietetic Association.  They all believe, to one degree or another, that the chronic illnesses plaguing modern Western society are caused by an unhealthy diet and lifestyle, and that improved health comes from eating fewer animal products and a more plant food-based diet.
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Avatar_m_tn
The diseases believed to be caused by meats, egg, and dairy products include most cases of: obesity, heart diseases, adult diabetes, breast, colon, and prostate cancer, gallbladder disease, osteoporosis, kidney failure, kidney stones, multiple sclerosis, rheumatoid arthritis, constipation, diverticulosis, hemorrhoids, and hiatal hernia to name a few well studied diseases.  You don't have to be a trained nutritionist to see the risk of becoming sick increases the more of these unhealthy foods that are eaten--like with high-protein diets.

Protein Damage

Protein is metabolized by the liver and excreted by the kidneys into the urine.  A high protein load causes damage to these organs.  By the eighth decade of life people in affluent societies commonly lose about 30 percent of their kidney function (J Gerentol 31:155, 1976).  This loss is believed to be secondary to overwork of the kidneys caused by the amount of protein typically consumed on the American diet, 12% to 15% protein (N Engl J Med 307:652, 1982).  The Zone diet recommends 30% protein, and even more protein is found in other high-protein diets.  Low protein diets (4% to 8%) are used routinely to treat patients with liver and kidney failure.

High protein diets cause serious metabolic changes that lead to bone loss and kidney stones. Red meat, poultry, fish, shellfish, and eggs are acidic in make up. Vegetable foods are alkaline by nature.  The body guards its acid-base balance (pH) carefully so that all of the pH-dependent biochemical reactions take place normally.  The dietary-derived acid load from high-protein animal foods must be buffered.  The primary buffering system of the body is the bones which dissolve for that purpose into phosphates and calcium.  The alkaline phosphate then buffers the animal-food derived acid.  This is the first step in bone loss that leads to osteoporosis.  The second step leading to osteoporosis consists of changes in kidney physiology caused by the acid, the sulfa containing amino acids (plentiful in meat), and the increased solute load, all resulting in a loss of large amounts of bone material, including calcium, into the urine.  The presence of this bone material in the kidney system also lays the foundation for calcium-based kidney stones.

The Nurse's Health Study recently found women who consumed 95 grams of protein a day compared with those who consumed less than 68 grams a day had a 22% greater risk of forearm fractures (Am J Epidemiol 143:472, 1996).  Metabolic ward studies done on people have found a negative calcium balance is created when 95 grams of protein are consumed with 500 mg of calcium.  The calcium intake must be raised up to 800 mg before calcium balance is achieved (the calcium entering the body is the same as the amount leaving).  People following the Zone diet commonly consume 100 grams of protein and less than 800 mg of calcium.  Athletes attempting to follow the Zone diet will consume 140 grams or more of protein a day.  Even with a very high calcium intake of 1400 mg daily these people are still in negative calcium balance.
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Impossible Advice

On June 9, 1997, I met Barry Sears, the author of the number one national best seller, Entering the Zone, at Bally's in Las Vegas for the first of our 3 debates (see page 7 for more information).  After telling a crowd of nearly 4000 people the virtues of his diet for controlling insulin and eicosanoid levels with resulting weight loss and improved health, I proceeded to explain why his diet is merely a semi-starvation diet and like all such diets it is impossible to follow for any length of time.  I used Barry Sears as an example:

Barry Sears weighs 210 pounds and is 6'5" according to information from his book.  His diet is based on 30% of the calories from protein, 30% fat, and 40% carbohydrate.  He says he eats 100 grams of protein a day.  He has been following his diet for 4-5 years.  He says he is still on his diet because he still needs to lose more weight.

If Barry Sears eats 100 grams of protein that translates into 400 calories of protein (1 gram of protein = 4 calories).  Since the proportions of the diet are 30/30/40, this means he also consumes 400 calories of fat, and about 500 calories of carbohydrate.  His total calorie intake is therefore 1300 calories per day.  A conservative estimate of his actual needs would be over 2300 calories a day, with only sedentary activity.  This means every day he is 1000 calories short of his needs.  Every week he comes up 7000 calories short, which must be made up from his fat stores.  One pound of fat amounts to 3500 calories.  Therefore, Barry Sears must lose 2 pounds of fat a week on his diet.  Every year by calculation he loses 104 pounds.  Since he says he has been on his diet for 4 to 5 years this means he has lost over 400 pounds.

At this point in the debate I asked him, "Barry Sears:  A) Did you start your diet at over 600 pounds?  B) Do you defy the laws of nature?  or C) Is it that you cannot and do not follow your own diet?"

Like all calorie restricted diets, the Zone diet is next to impossible to follow for very long because it hurts to be hungry.  His program is also impossible because the dietary rules are complicated and foods recommended are unhealthy and unappealing.

Coincidentally the June issue of Prevention Magazine came to the same conclusions.  They made up a day in the Zone for their article.  The meals consisted of 6 egg whites, ½ cantaloupe, 1 kiwifruit, and 3 macadamia nuts for breakfast, Lunch served  3 oz. of skinless white chicken, 1 cup each of steamed asparagus, broccoli, green beans, and 1 tsp of olive oil.  Dinner was 3 oz. of turkey breast salad, 4 cups of spinach, 3 cups of cucumber slices, 2 tomatoes, and 1 tsp. of olive oil.  Afternoon snack was ¼ cup of low-fat cottage cheese, ½ medium pear, and 3 olives.  Evening snack was ¼ cup egg substitute (scrambled), 1 medium plum, ½ tsp. natural peanut butter.  This provided 1,209 calories, 110 grams of protein (37%), and 646 mg of calcium.  The authors of this article asked "How long could you eat this way?"
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During the next round of the debate I pointed out that Barry Sears had not answered my question. Therefore, I must assume he cannot and does not follow his own diet.  He admits to only 35 pounds of weight loss over the past 4 years (less than 9 pounds a year), therefore he must be consuming at least 2300 calories a day.  This leaves two possibilities:

If he is following his rule that to be in "the zone" you must adhere to proportions of 30/30/40; then based on a 2300 calorie intake he must be eating 173 grams of protein and 77 grams of fat daily (1 gram of protein = 4 calories and 1 gram of fat = 9 calories).  Therefore he must be in a high-protein, high-fat  zone.  However, he admits to eating only 44 grams of fat a day, so the next possibility is more likely.

If he follows his rule that he eats a specific amount of protein daily to be in "the zone" and for him that's 100 grams of protein a day;  then based on 2300 calories of a day his diet would be 17% protein, 17% fat and 66% carbohydrate, which would place him in a high-carbohydrate zone.

My next question to him was, "Barry...please tell us--are you on a high-protein (Atkins-Type) diet or are you on a high-carbohydrate (McDougall-Type) diet?"  He still wouldn't answer.  He finally said something about not being interested in weight loss, but was really trying to protect himself from heart disease, since he has a strong family history.

The Heart Disease Zone

Seems kind of strange to think of a diet centered around beef, pork, lamb, chicken, eggs, bacon shrimp, lobster, and cheese  preventing heart disease.  But, Sears reasons that too much insulin production by the body is the primary culprit for causing heart disease, and the Zone diet will control insulin and prevent heart disease.  He feels so strongly about this that he claims in his book that a very low-cholesterol, low-fat diet will actually cause heart disease.  After looking over Dr. Dean Ornish's research he concludes, "My guess is that the people who stay on his (Ornish's) program will ultimately have more heart attacks, more strokes, and a higher cardiovascular death rate than the dropouts."  He bases this on the fact that "good" HDL-cholesterol went down in Ornish's patients and triglycerides went up.  
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During the debate I pointed out to him that Ornish had corrected him over a year ago, by providing him the data showing his patients on a high-carbohydrate diet had a 50% decrease in risk of cardiovascular deaths.  Sears admitted his error to Dr. Ornish and promised to make corrections in his book, but has not.

On a healthy low-fat, low-cholesterol diet "good" HDL-cholesterol goes down because all fractions of cholesterol go down.  Worldwide the lowest incidence of heart disease is found where people eat the lowest cholesterol diets and also have the lowest HDL-cholesterol levels (2:367, 1981).  Feeding cholesterol raises HDL-cholesterol (N Engl J med 325:1704, 1991). A long-term study of patients on a high-carbohydrate diet showed less risk of death from heart disease compared to those on the American diet (JAMA 173:884, 1960).

More Zone Nonsense

Barry Sears makes numerous statements in his books and at public appearances that are incorrect, and I believe he is well aware of the inaccuracies, but refuses to correct them.  Much of this same misinformation is used by promoters of other high-protein diets.  Examples include:

Fat Doesn't Cause Obesity:

Sears:  Eating fat doesn't make you fat.  We are consuming less fat than 10 years ago and getting fatter, therefore dietary fat cannot be the culprit.

Truth:  We are consuming the same amount (actually a little more) of fat now than before.  But, in addition, we are consuming over 250 more calories of refined flours and sugars over the past 15 years.  Because of the added refined carbohydrates, the percent of fat in the diet has gone down between 1980 and 1990 (men 38% to 34%, women 37% to 34%), but the actual amount (grams) of fat consumed has remained the same (men 99.8 to 98.8, women 62.6 to 67.8), and the diet American diet now has more calories (men 2,457 to 2,684, women 1,531 to 1,805).  The reason for the rise in obesity is no mystery--Americans eat a high-calorie, high-fat diet.
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Carbohydrates Increase Heart Disease

Sears:  A high-carbohydrate diet for cardiovascular patients may be dangerous to their health. Experiments show high carbohydrate diets increase the risk factors for heart disease, by raising cholesterol and triglycerides, and lowering HDL-cholesterol.

Truth:  You can design such experiments to show triglycerides go up by feeding refined carbohydrates to subjects, and by overfeeding subjects (cholesterol still goes down and I explained the effect on HDL-cholesterol above).  When subjects are allowed to eat only until they are full (not force-fed) their cholesterol level falls, their triglyceride levels don't go up significantly, and they lose weight (JAMA 274:1450, 1995).  A study of 1250 of my patients shows triglyceride levels decrease an average of 10 mg/dl, and people who start with levels over 600 mg/dl have a 311 mg/dl reduction in 11 days.  Therefore, eating as much as you want (but not more than you want) of a healthy low-fat, no-cholesterol diet lowers three important risk factors for heart disease--cholesterol, triglycerides and body weight.

Rice Means More Heart Disease

Sears:  The Chinese are an example of how people on a high carbohydrate diet (rice) are as likely to have heart disease as Americans.  Using the American Heart Association data, he points out, Urban Chinese have almost as much cardiovascular disease as in the US.

Truth:  Cardiovascular disease is not the same as heart disease.  In China, half of this cardiovascular disease is represented by strokes (from old age and high-salt diets), less than one-third is due to heart attacks (ischemic heart disease).  In the US nearly two-thirds of the cardiovascular disease is due to heart attacks (and one-sixth is due to strokes).  Besides, the 1993 figures he uses reflects the modern Chinese diet, which much higher in fat and cholesterol than a few years back, especially for those people in the cities (urban)
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Fat Improves Athletic Performance

Sears: Athletes perform better on a high-fat diet.  A high carbohydrate diet is overrated for elite athletes.  A high-carbohydrate diet actually limits the performance of highly trained endurance athletes.

Truth: Carbohydrate, not fat, is the primary fuel for exercise at or above 70% of aerobic capacity, the intensity at which most people train and compete.  Fat only becomes available for fuel after 20 minutes of exercise; therefore most people never exercise enough to lose body fat.   Almost every study of trained athletes shows carbohydrate fed before and during  the event improves an athlete's performance. Carbohydrate fed after the event replenishes the athlete's glycogen stores for the next race.

Keeping Correct Insulin Levels

Sears:  Reaching "the Zone" requires precise control of the protein-to-carbohydrate ratio.  Protein counteracts the carbohydrates you eat to keep insulin levels in balance.  High levels of insulin generated by too much carbohydrate drive you out of "the Zone."

Truth: There is no evidence that eating equal amounts of protein and carbohydrate at every meal, as Sears suggests, lowers insulin.  According to Dr. Gerald Raven from Stanford University. "Protein--when eaten alone--increases insulin secretion.  I see no reason in the world why it would be any different if protein were eaten with carbohydrate" (Nutrition Action Newsletter Jul/Aug 1996).  A study from the Lancet found beef fed with glucose raised insulin levels twice as high as glucose alone and four-times as high as beef alone.  The authors concluded, "Ingestion of glucose plus protein is followed by a very large increment in plasma-insulin, of such a magnitude as to suggest synergism between glucose with aminoacid (protein) with respect to insulin release." (Lancet 2:454, 1966).  The diet fed these subjects met the zone specifications of 30/30/40 for ideal an protein-to-carbohydrate ratio: 27% protein / 30% fat / 43% carbohydrate.  A study of adult-type diabetics, people with insulin resistance, and normal people found 3-weeks of a high-carbohydrate, low-fat diet and exercise lowered insulin levels significantly (Am J Cardiol 69:440, 1992).
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Ecosanoids are the Key

Sears: Eicosanoids are the body's super-hormones.  Virtually every disease state--whether it be heart disease, cancer, obesity or autoimmune diseases, like arthritis and multiple sclerosis--can be viewed as an imbalance of eicosanoids.   To keep the eicosanoids in a healthy balance you need to eat three grams of protein for every four grams of carbohydrate.

Truth:  Sears bases his whole diet theory on these hormones, yet he has never measured the eicosanoid levels in people--so he really doesn't know the response to his diet.  Gerald Raven of Stanford says, "I find it hard to swallow that anyone could really believe eicosanoids are the key to all health and disease" (Tufts U Diet & Nutrition Newsletter, May 1996).  William Evans, PhD, director of the Noll Physiological Research Center at Penn State University says, "There aren't any studies that I'm familiar with that suggest they're dangerous in any way.  Anyone who tries to sell diet as the key to stemming ‘bad' eicosanoids is capitalizing on an unfounded idea" (same Tufts Newsletter).

What to Tell Your Friends

"You can burn more fat watching TV than by exercising" and "...many people following high-carbohydrate diets might just as well be eating candy bars" are some of the ridiculous statements found in Sears' book and people still want to believe him; therefore, it seems like an impossible task to try to help those friends and family members who are attracted by "high-protein diet preachers."

Try to get them see the big picture.  If carbohydrates were bad for people then the Japanese living in Japan on a rice-based diet would be fat and sickly.  When they moved to the US and switched to a lower-carbohydrate, higher-fat and -protein diet they would become thinner and healthier.  The truth is the Japanese are among the slimmest, most energetic, longest lived, healthiest people on earth.  Furthermore, they take on common American diseases when they change to the American diet.  If high-protein diets, which means meat, egg, and dairy products, were so good for us then people who subsist on these foods (most Americans) would be the thin and healthy, and vegetarians would be fat and sick.  In general, the opposite is the case.

Along this same line of thinking, ask your friends to closely observe the personal appearance of these experts making all these dietary recommendations.  You will be struck by how fat and sickly most of them look.  From where I stand, I must conclude that they do eat high-protein foods and lots of them.

In the long run these controversial diets are extremely important (even though some people get hurt along the way).  The worst thing that can happen to the truth is for people to show no interest.  This high-protein craze has made the country's top doctors, dietitians, nutritionists, sports experts, and other scientists closely examine the scientific research on nutrition and health.  Almost every article on the subject these days brings up the damaging effects of protein on bone health leading to osteoporosis.  Before this controversy all they would talk about is the need for calcium.  The harm from eating refined foods, and sugars in all forms of the very popular nonfat cookies and cakes is now being emphasized.  Soon the pendulum will swing back to a high carbohydrate, vegetarian diet and hopefully more people will make this their lifestyle as the truth becomes more widespread.  (Read the preface of the McDougall Plan to see the historical scope of this debate)
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Just want to add that I presented the "McDougal VS Ornish" debate, not because I have come to a firm conclusion, one way or another -- but to point out my confusion after studying -- and trying -- both of these types of diets over the years. I am still confused, to say the least, but in my heart of hearts, I do believe -- if I could adhere to it -- that a very low fat diet, based on whole grains and vegetables with some lean meat/.fish -- probably would be my ticket to relative longevity. Again, if I could adhere to it.

-- Jim
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Sorry -- that would be the "McDougal VS *Sears* debate". The Dean Ornish diet, as well as Pritikin is more similar to McDougal, although I believe McDougal is vegetarian, not sure on that, but it is a very low fat, low protein, high complex carb diet.
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Ditto

HR said the same thing in as many words

Have a great weekend!

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I believe HR's diet is more akin to the Barry Sear's Zone diet, and not the low fat, low protein, McDougal diet, but I won't speak for HR. I have tried both types of diets after being swayed by both authors. Both btw are difficult to follow and at least for me had a positive effect on my cardio lipid profile. However, the low fat, low protein diet (the non-zone diet) lowered total cholesterol more and also lowered my liver enzymes pre-treatment. The Zone diet raised my HDL the most and lowered my Tri's the most but raised my liver enzymes. I believe I could have controlled tri's better on the McDougal type of diet had I watched the simple carbs more, which was difficult to do with such a limitation on fat and protein.

-- Jim
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Unlike the Zone diet, to slow carbohydrate absorption, diets like McDougal rely more on the fibrous nature of the food components themselves -- complex carbs mostly -- as opposed to embedding certain foods within foods (eating in protein/fat/carb) combinations such as with the Zone diet. In other words, you can eat fruit by itself on McDougal, while on the Zone diet, you would for example always want to balance an apple with a little fat (say "x" almonds) and a little protein (say "x" ounces of chicken").
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Therefore on these types of diets, an ideal snack might be whole wheat rice cakes, which would be forbidden on the Zone diet because it would not be balanced out as well as following much too high on the glycemic index. Had I eaten more rice cakes -- and less bagels -- maybe my tri's woudn't have been as high. Another component of these diets -- the Zone as well -- is lots of aerobic exercise. In fact, while revised, the original Pritikin book recommended TWO HOURS of brisk walking per day. No doubt that helped normalize tri's for those that followed the regimen.
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Well, your the only one around here that tested enzymes during different diets. I'm kinda inclined to lower the 30% protein with every meal amount that HR suggests. Tried the 30% and had a headache all last night. Never have headaches. Could be from reading this forum.

I guess the trick would be to get one's daily diet on a piece of paper and slowly modify it until it looks perfect. Good books aren't written, they're edited, no?

Still open to insights from everyone.
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Scratch: Never have headaches. Could be from reading this forum.
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Probably. But as to the diet angle, while I never got headaches on the Zone -- I rarely get them anyway -- I did have trouble thinking, concentrating and writing. For me, at least, I seem to need a lot of carbs/glucose to the brain in order to function. Once that is cut down, a la zone, my mind tends to race as opposed to 'relax' which at least for me allows me to think. My best "thinking" breakfast is oatmeal, banana, whole wheat toast and skim milk.

Of interest is why some Yoga's don't eat a lot of protein. At least to one very high-up head stander, the reason had to do with meditation. "Too much protein and the mind cannot be still, it will race and wander" he told me.

Bottom line, however, is that most of this stuff is measurable. Measurable in the sense that you can measure how you feel from a particular diet. And measurable in the sense that you can measure the effect of a particular diet by doing blood work before and during. And don't forget the exercise part. Without it, many of these diets just won't work nearly as well.



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My best "thinking" breakfast is oatmeal, banana, whole wheat toast and skim milk.
____________________________________

Yeah, me too. I leave out the wheat toast but only because I'm full. Sometimes I'll just throw the 10am baggie of veggies in the blender with a banana and some protein powder what.

I changed my picture, IM your address. So I can send you your freakin Xmas present and move on with life.

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I thought you were going to substitute a less scary picture.

But seriously, I do appreciate the offer and maybe someone else will take you up on it, cause the publication looks interesting and I just might spring for the ten bucks. Just that I'm uncomfortable giving out my address on the internet even with private mail. Maybe if those black helicopters would stop following me.

-- Jim
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You flatter yourself too much. You're are only important to me in one context, this forum. . . .very important.

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You know I was kidding about the picture and -- assuming you're not kidding me back -- I'm  not flattering myself, just a privacy thing I've developed from some past experiences on the net.
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Yeah, well, when you cast your lot. . . . .
I've moved on. Gotta pack my bags for my ski trip. Maybe my last ever.

Having Oat Bran for dinner, yum. Now, if I can figure a way to stick this can of wild atlantic salmon in without gagging I should have a wele rounded meal.

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