Too Much Protein?

A ketogenic diet is any diet that puts you into ketosis. The issue isn’t only what raises your ketone levels but also what lowers them. It is glucose that keeps you out of ketosis and that generally means restricting carbohydrates. But glucose can come from other sources. This is where protein come in. It has been a common view that too much protein would keep you out of ketosis. The theory was that gluconeogenesis, the process that turns proteins into glucose, could interfere with ketosis. So, some have worried that too much protein was basically no different than too many starches and sugar.

That view has been challenged by more recent research. The newer understanding is that gluconeogenesis is mostly demand-driven, not supply driven. That said, it’s more complicated than that. There are conditions that can alter demand or else signaling. Benjamin Bikman, an insulin researcher, advocates a higher protein ketogenic diet. He says that initially it might matter when someone first goes onto a ketogenic diet, if they have hyperglycemia and hyperinsulinemia, a problem for far too many Americans. But as insulin levels are normalized, which can happen quickly, gluconeogenesis is not a problem.

So, it depends on how healthy you are. With insulin resistance, high protein intake might spike insulin and cause the insulin glucagon/ratio to become imbalanced. Yet for a person with a healthy metabolism, the glucose/insulin ratio might not change at all. As Ben Wagenmaker explains it, “Studies do show that GNG affects obese people and diabetics, in that excess protein produces measurable spikes in blood glucose levels, although this same effect has not been observed and quantified in non-diabetics that are not obese” (Gluconeogenesis, Chocolate Cake, and the Straw Man Fallacy).

Considering that most Americans are obese, diabetic, pre-diabetic or insulin resistant, it might be advisable to limit protein until one has become fat-adapted and metabolically flexible. It’s easy to figure out for yourself, though. You can simply measure such things and see how it is affecting you. Or you can go by an even simpler method. Once your body is regularly in ketosis, fasting should become easy. If you can skip meals or go a day without eating at all and not be particularly bothered by it, then you know you’re body has fully adjusted to ketosis. At that point, protein should no longer be a concern.

This is good to keep in mind, considering most people turn to specific diets later in life. Bikman points out that, as people age, the body requires more protein for health. That is because the body becomes less effective at using protein. And if you don’t get enough protein on a keto diet, the body will cannibalize muscle.  A lack of protein, in general, can be problematic — look at how lacking in musculature are many vegans with limited protein and lower quality protein. Muscle loss is a major health hazard for senior citizens, but muscle loss can begin much earlier in life.

* * *

Dietary Proteins Contribute Little to Glucose Production, Even Under Optimal Gluconeogenic Conditions in Healthy Humans
by Claire Fromentin et al

Dietary Protein and the Blood Glucose Concentration
by Frank Q. Nuttall & Mary C. Gannon

The relationship between gluconeogenic substrate supply and glucose production in humans
by F. Jahoor, E. J. Peters & R. R. Wolfe

More Than You Ever Wanted to Know About Protein & Gluconeogenesis
by Amy Berger

If You Eat Excess Protein, Does It Turn Into Excess Glucose?
by L. Amber O’Hearn

Protein, Gluconeogenesis, and Blood Sugar
by L. Amber O’Hearn

Ketosis Without Starvation: the human advantage
by L. Amber and Zooko Wilcox-O’Hearn

The Ultimate Guide to the Carnivore Diet:
How can carnivore diets be ketogenic when they have so much protein?
by L. Amber O’Hearn and Raphael Sirtoli

What is gluconeogenesis? How does does it control blood sugars?
by Raphael Sirtoli

the blood glucose, glucagon and insulin response to protein
by Marty Kendall

why do my blood sugars rise after a high protein meal?
by Marty Kendall

Gluconeogenesis – The worst name for a rock band ever
by Tyler Cartwright

Protein Over-consumption in Ketogenic Diets Explained
by Ken Adkins

Will This Kick Me Out Of Ketosis?
by Dustin Sikstrom

Keto Problems: Too Much Protein?
by Keto Sister

Dietary protein does not negatively impact blood glucose control.
by Bill Lagakos

 

The Fad of Warning About Fad Diets

Over at the Hurn Publications blog, the author warns against “fad diets”, specifically ketotarian diet, snake diet, and peganism. Let me clear up a few misconceptions. First off, none of these diets are exactly a fad. Various populations have been following diets like these for as long as humans have been around. There are many anthropological and historical examples that can be pointed to.

One-meal-a-day (OMAD) diets like the snake diet were practiced by the Spartans and Romans, but OMAD is common among hunter-gatherers as well. It is the three-meals-a-day-with-multiple-snacks-between diet that is bizarre by the standards of history and evolution. OMAD is one way to dispose the body to ketosis, especially if the diet is at least somewhat low-carb as were most diets in the past. Many populations would be ketogenic for long periods of time, such as during winter when starchy and sugary plant foods were scarce. Mongol warriors under Genghis Khan did extended fasts before military campaigns that would’ve put them into ketosis and then following that typically only ate meat, blood, and milk paste; although they might eat any food available in a city once conquered.

It’s not unusual for hunter-Gatherers like the Piraha to eat all the food they can take in at a time, sometimes until their stomachs are distended, as food can’t easily be stored, and then sometimes not eat for days. This is the standard feast and fast style of eating that was common throughout human evolution and remained far from uncommon around the world until the agricultural surpluses of past century or two. Fasting was a typical and regular practice among Europeans into the Middle Ages. On a related note, most Europeans and Americans didn’t start fattening up their cattle and themselves with grains until the 1800s. By the way, the Piraha’s fasting, intermittent and extended, would have left them in ketosis fairly often. There wasn’t much that would kick them out of ketosis since starchy plant foods are limited in their diet, such as occasional tubers. Ninety percent of their calories come from animal foods, mostly fish.

I might add that nothing equivalent to a baked potato, french fries, or potato chips were a part of the human diet until agriculture. the few wild tubers hunter-gatherers had access to were extremely tough and fibrous, hard to obtain, prepare, and eat (with chewing each bite being a slow process followed by spitting out a big wad of indigestible fiber)— and not nutrient or energy dense for all the work that went into using them in the diet. Most wild plants are extremely fibrous which is why hunter-gatherers got so much fiber in their diet, even when they didn’t eat a lot of plants. Modern plant foods have far less fiber and far more starch and sugar, not to mention nutrient-depleted.

Peganism would be the closest to a fad diet. But it really is rather moderate. It’s mostly about balancing foods for optimal nutrient content and bioavailability while eliminating the foods most often problematic for people. If followed carefully, there is no nutrient one would lack. It fits well within the evolutionary boundaries of human eating. The diet emphasizes food quality including large amounts of nutrient-dense plant foods and does allow moderate amounts of meat, fish, and eggs; but like paleo diet, it restricts foods not eaten for most of human evolution: grains, dairy, and legumes. I should point out that peganism is far from being the only paleo-style diet that heavily emphasizes a plant-based approach. There is Dr. Terry Wahl’s protocol and Dr. Will Cole’s ketotarian diet, both former vegetarians who now recommend ketosis. Like Mark Hyman with his peganism, Wahl’s protocol and ketotarianism allow moderate amounts of animal foods and Wahl’s protocol only recommends ketosis for some people.

Consider that all of these diets fit the profile of what we know of hunter-gatherer and other traditional diets from historical accounts, the anthropological record, and from archaeological evidence. There have even been dietary studies that have measured the macronutrients and micronutrients of hunter-gatherers. We still need to know a lot more, but we are far from merely speculating in ignorance. We do know, for example, that after everywhere agricultural foods were introduced there was a deterioration in height, cranial size, and general health. The vast majority of humans survived and thrived for hundreds of millennia without agricultural foods, without nutritional deficiencies, and without diseases of civilization. Sometimes people point to the high infectious rates of hunter-gatherers, but the infectious rates of agriculturalists was much higher and, besides, many of the infectious diseases harming hunter-gatherers were introduced by agriculturalists (e.g., malaria). Excluding high death rates from infections in childhood, the average lifespan of hunter-gatherers is about the same as a modern Westerner.

Ketosis has always been a normal state and, until quite recently, a state that humans entered into on a regular basis — since constant and unlimited access to carbs was unusual in the past. Ketosis doesn’t trick the body into a pseudo-fasted state. It is its own physiological state, one of the ways of fueling the body, what some argue as being the original preferred fuel in how the body uses it so well. So many diseases are related to glucose and insulin resistance, in a way not seen with ketones and ketosis. Quite the opposite in fact, since ketosis has been used to treat numerous diseases: epileptic seizures, diabetes, multiple sclerosis, Alzheimer’s, autism, ADHD, etc. In particular, a ketogenic diet is one of the best options in the world for blood sugar conditions and one would be insane to not advise cutting out carbohydrates. And there isn’t necessarily a reason to worry about problems with eating disorders, as ketosis is well known to make cravings disappear and improve diverse psychiatric disorders, but it would have to be decided on an individual basis in working with a doctor. Since the Hurn Publications article appears to be written for or promoted by the Cancer Wellness Center, I’m surprised the author didn’t bring up the contentious debate over cancer’s relationship to glucose, specifically in relationship to diet — there are recent books that discuss the science. No matter which side of the debate one falls on, the debate should at least be mentioned.

There is a lot of research out there right now and it is accumulating quickly (including that of Dr. Terry Wahls and Dr. Dale Bredesen, both with books out). It’s been studied for almost a century at this point and it is well understood. I might suggest not worrying about being in ketosis in the scientific sense, unless you have a serious medical condition. The scientific measurement for the amount of ketones to be called ‘ketosis’ is somewhat arbitrary. Even at lower levels of ketones, many of the same benefits are seen. And any significant level of carb restriction will produce more ketones. It doesn’t matter if one occasionally slips out of ketosis. But if one is concerned about this, there are multiple ways of measuring ketones at home.

Even millennia ago, physicians would use ketosis to treat some conditions, although they didn’t have the knowledge of what ketosis was and they were mostly limited to using fasting to induce it. The Chinese observed how the Mongols on their ketogenic diet could ride and fight for days without stopping to eat. That is the power of beta-hydroxybutyrate, the human superfuel. It’s the reason humans were able to cross deserts and oceans with little food or else go without while tracking down, sometimes over days, the next meal. You can’t do that with carbohydrates. Even more awesome is that ketosis creates the conditions for autophagy, which is how your body heals from damage and, by activating stem cells, building new cells, including in the brain. Both ketosis and autophagy reduce inflammation, a major reason for the health benefits, but reversing insulin resistance and bringing diabetes under control is no small feat.

More broadly, low-carb diets are even less of a fad. They’ve been discussed by medical professionals and scientific experts going back to the 1700s and have been well known and widely used since the 1800s. Compare that to fad diets like that of the high-carb/low-fat that has been recommended in the mainstream only for about a half century now. If you are worried about “essential vitamins, minerals, fiber, as well as anti-oxidants and phytochemicals in a healthy diet to support wellness”, then these supposed “fad diets” can be a major part of it. Most people focusing on these kinds of diets tend to be highly informed about potential nutritional deficiencies and about the sources and bioavailability of nutrients. Their obsession with nutrient-density might turn some people away. Peganism explicitly is about nutrient-density as are other forms of the paleo diet, but the ketogenic and snake diets are easily adapted to nutrient-density (e.g., ketotarian). This sector of the diet community is one of the last places one would expect to find malnourishment.

As for the fear-mongering about side effects, there is far less to worry about health-wise on any of these diets than what you are likely to experience from what is recommended in the mainstream. Few people experience side effects and most people experience dramatic improvements, unlike seen on conventional diets. And these dramatic improvements tend to be permanent, not transitory. Ketosis, OMAD, peganism, etc are about changing your dietary lifestyle and fundamentally changing how your body functions. Opposite of what the Hurn Publications article warns, you are less likely to feel “hangry” (hungry and angry) on the snake diet, as you’d be spending most of your time in ketosis. It’s on a diet of constant carbs that people tend to get hangry. These kinds of diets aren’t merely or primarily about losing weight. They can transform the way you feel and even the way your brain operates. There are plenty of people who explain the science behind why this happens, if you’re motivated enough to dig into the details.

The author is right about focusing on nutrient-density, but that is an irrelevant point in terms of criticizing these diets, as I already explained. Even less relevant is the continued focus on calories. If you are eating satisfying and satiating nutrient-dense foods while avoiding carbs that cause cravings, you probably won’t need to worry about calorie counting and portion control. There is a good chance you’ll naturally find yourself only eating the amount of food your body needs. These “fad diets” readjust your taste and hunger. There is nothing simpler and easier than that.

* * *

This post is critical of what I perceived as unfair criticism. But it wasn’t intended to be mean-spirited. As for many people, diets touch upon the personal for food is central to life. And as with others, I’ve used diets in seeking health.

The reason I started following the Hurn Publications blog is because of a piece on the EAT-Lancet that I appreciated. I think I linked to it in my own writing about the topic. That brings me to a concern. We were both critical of EAT-Lancet and so there was some basic agreement. But this latest post of mine is about disagreement.

So what exactly bothered me? One thing is that the attack on fad diets is precisely what turns people toward such things as EAT-Lancet that, in the end, is simply a repackaging of status quo dietary ideology. The advice given in the recent Hurn Publications post fits perfectly in with the EAT-Lancet diet, despite their earlier post rightly discrediting EAT-Lancet.

There is an inconsistency there. But also it puts the two posts at the same blog at cross-purposes. No one can serve two masters. Challenging and defending the status quo are separate positions. Speaking of fad diets is to use the language of the status quo, which is simultaneously misleading since the closest to a fad diet is the status quo.

Human Adaptability and Health

What makes humans unique? There are many answers that can and have been offered. My own dietary experimentation, from paleo to keto to carnivore, has led to certain thoughts. After two months of carnivory (and before reintroducing plant foods), I ended it with an extended fast, three days to be precise, as inspired by Siim Land. There is something impressive about fasting, far beyond its intermittent variety. Yes, ketosis is involved, but lengthening the fasting state steps it up to a whole other level, specifically to be scientific what is called autophagy along with stem cell activation. With autophagy, your body cannibalizes damaged and dead cells in order to build entirely new cells, including in the brain, and in the process of three days of fasting every cell in your immune system will be replaced. That is pretty kick ass!

More basically, fasting simply feels good or it can, assuming one isn’t sick or stressed. It’s not as hard as one might think, assuming one begins it in a state of ketosis and fat-adaptation. That is the way it has been for me, in the several extended fasts I’ve done. I’ve even done part of the time in dry fasting, that is to say not even water. With fasting, energy doesn’t necessarily decline and sometimes there is a boost of energy, specifically when ketones kick into high gear. And even without water, the body shifts into a different mode and one doesn’t get thirsty, at least not for many days (breathing through one’s nose helps as well), since the body stores water similar to how it stores fat. Fasting has been a practice among probably every traditional society that has ever existed, from early Native Americans to early Europeans, and is found in diverse religions, from Buddhism to Christianity — fasting only became uncommon since vast food surpluses were created in recent generations.

I’ve done fasting in the past, but I always limited myself to one-day fasts. It was never difficult and, even though few people ever do it, I never considered it an impressive feat of personal strength and willpower. It simply meant not eating food for a time. More interesting on a personal level was a different kind of fasting. Maybe a couple of decades ago, I got into the habit of jogging before eating and I would sometimes go for hours. I never lacked energy and, if anything, I had more energy than before I began. A strange side effect was that my hunger also decreased for the rest of the day, a rather counter-intuitive result as one would think exercise would make one hungry to make up for the calories lost.

I didn’t understand it at the time, but I had independently discovered ketosis. Once you run out of glucose in your blood and glycogen in your muscles, your body switches to turning fat into ketones. As long as you have enough fat (not a problem for most people), you can continually produce ketones for long periods of time without any food. Even the small amount of glucose your body needs can also be produced by the body without any need of dietary intake of carbohydrates. For a fat person, they literally can go months without food, as the body doesn’t only store energy in body fat but also nutrients. Cole Robinson of Snake Diet fame is an advocate of this method of fat loss — as he puts it, If you want to lose weight, fatty, stop stuffing food in your mouth. While in this state, you can remain active. The Piraha, according to Daniel Everett, would regularly go without eating on some days for no particular reason and at times would dance for several days without stopping for a meal. Cole Robinson talks about continuing his heavy weight lifting routine many days into fasting, not that most modern people with inferior health would want to try this. Under Genghis Khan, Mongol warriors began their war campaigns with an extended period of fasting, maybe to prime their body for ketosis that they maintained with their low-carb and animal-based diet (mostly meat, blood, and milk).

This relates to our evolutionary needs. Early humans survived as a hunting pack. We aren’t the fastest animal, among either predators or prey. We are rather slow actually and our lack of claws and fangs are a disadvantage, but we are endurance runners with the capacity to develop immense tracking skills. Along with ketosis that puts our large brains into overdrive, particularly the use of the pseudo-ketone beta-hydroxybutyrate, we have a special knack for sweating that keeps us cool, partly because of our lack of fur. Also, because of our upright position, our lungs aren’t constricted by our running gait and so our breathing is free to follow it’s own rhythm. Humans did all this while being barefoot for most of our existence, often running across rough ground. In particularly harsh environments such as Australia, the natives would develop thick callouses on the soles of their feet. We run better and more safely without shoes than with them — barefoot running (or using thin footwear such as sandals or moccasins) forces us to use good running form with impact shifted toward the toes rather than the heels. As natives observed, most animals move with the weight put on their toes. This is also what we humans are designed for.

Running is what humans do. Hunter-gatherers can track animals for days without having to stop for food and water and, as long as there is a water supply, could go on for weeks without food. This is natural. This was once the norm. This is how the human species managed to travel across deserts and oceans, how our ancestors survived starvation and ice ages. For hundreds of millennia, humans maintained such high levels of physical strain typically without harm to their health and rarely with injury. Fasting and feasting. Extended activity and periods of rest. And we are able to retain our physical capacities well into old age. Hunter-gathers in their sixties have the same level of running ability as they had in their late teens, with the developmental peak hitting around the late twenties. Many individuals in traditional societies go on running as their normal mode of travel until the day they die and, excluding early deaths from infection (infections, I might add, that mostly were introduced through colonialism), traditional people live as long as do modern Westerners. As said by Geronimo, a man who lived and fought under fierce conditions into older age, “My only friends are my legs. I only trust my legs.”

Even cold weather is not a big issue. An intriguing side of ketosis is that it has a built-in inefficiency. Burning fat produces excess heat, that is to say wasted energy. As Benjamin Bikman has speculated, this is likely because ketosis most often has occurred in the winter. The extra heat was a side benefit. So, fasting will not only give you immense energy from the superfuel of ketones but keep you warmer as well. Cold temperatures, like fasting, also promote autophagy which is healing. The body goes into its most optimal mode of functioning. Humans who are adapted to it can swim in freezing cold water for long periods of time or hike barefoot and half-naked in the snow as Wim Hof has demonstrated and, shown in research, all humans have such capacity for cold adaptation — it’s related to meditation techniques of warming the body where one sits in snow or on ice until it melts. Cold bathing and sleeping out in the open on cold nights, including with little clothing has been done by numerous populations: Australian Aborigines, Native Americans, etc. Make it a practice to take cold showers and you’ll get some small sense of the effect this can have — something I’ve been doing for a while and, to say the least, it is invigorating, but I’ve always been one of those crazy people who will go outside in the winter underdressed. By the way, Wim Hof at the other extreme has also run a half marathon through a desert without water. He has set many other world records, twenty-six in total.

Humans are adaptable, but a too easy and comfortable lifestyle has caused modern people to lose their adaptability. We aren’t meant to always be at the same temperature, always eating, always sedentary, or always anything else. Pushing the biological boundareies is a good thing to do on a regular basis. Consider hormesis — small amounts of stress actually increase our health. A similar thing is seen with exposure to bacteria and parasites when younger that can strengthen the immune system for life and alter how our bodies function. Even in seeking health, we moderns often get it wrong. We aren’t meant to continually do the same exercise in the same way over and over. Variety isn’t only the spice of life for it is also the meat of life. If we don’t use it, we lose it. This is why we should alternate how we exercise.

One method designed for this purpose is high-intensity interval training (HIIT) which is alternating between strenuous activity to exhaustion with periods of rest and repeating this multiple times. It forces the rhythm of your heart rate to expand its variability and that is good thing. Continuous exercise at the same pace, such as typical long distance running does the opposite in decreasing this variability. This is what can sometimes cause seemingly health long distance runners, once reaching the finish line, to drop dead from a heart attack. The lack of heart rate variability strains their heart too much in going from running to stopping. But this could be easily prevented by doing some HIIT exercise such as wind sprints, something I did a lot as a kid during soccer practice. Sometimes walk, sometimes jog, and sometimes run as fast as you can. That is what most of us did as children when playing and often we did it barefoot — I recall running on gravel alley barefoot, walking through the woods barefoot, and climbing trees barefoot. Why do we forget such natural behavior as we become mature, respectable adults? Don’t exercise. Just go play outside.

Our loss of connection to our species inheritance has cost us our health. But this loss isn’t an inevitable fate of modern civilization. We should take advantage of what we now know about human physiology. We humans are amazing creatures. There is a reason we have survived and thrived and spread all over the earth in nearly all environments and ecosystems. Even with all the unnatural strain and harm we put ourselves under, we still somehow manage to keep many of our physiological abilities. Imagine what we could accomplish if, rather than being sickly, our society operated with optimal health.

* * *

Persistence hunting
from Wikipedia

Endurance running hypothesis
from Wikipedia

Endurance Running and Persistence Hunting
by David Carrier

Running After Antelope
from This American Life

Running After Antelope
by Scott Carrier

Born to Run
by Christopher McDougall

Why We Run: A Natural History
by Bernd Heinrich

Becoming the Iceman
by Wim Hof

The Way of the Iceman
by Wim Hof

What Doesn’t Kill Us
by Scott Carney

Science Explains How the Iceman Resists Extreme Cold
by Joshua Rapp Learn

Breathe Like The Iceman: How To Use The Wim Hof Method
by Harry J. Stead

Obese Military?

I came across some articles on obesity and the military (see below). Metabolic syndrome, obesity being one part of it, is on the rise in the military and in the population in general, along with much else such as autoimmune and mood disorders.

Weight issues are not an issue of mere exercise, as I discovered in aging. The weight began accruing in my thirties and continued into my forties. I’ve always been active and so, in response, I became even more active. I had long done aerobic exercise multiple times a week, often long jogs and sometimes carrying extra weight. Weightlifting was added to my regimen these past few years. Still, the body fat wouldn’t budge. Besides, the worst rates of obesity are found among the young and so aging is not the issue, as further demonstrated by age-related diseases (e.g., what was once called adult onset diabetes) hitting hard at younger and younger ages.

Why is that? Some of it is basic biological changes in aging, of course — still, that couldn’t explain it all since it is happening in all age groups. I had improved my diet over time, but admittedly I was still eating a fair amount of carbs and sugar, even if no where near the amount the average American gets. In the wider population, the consumption of carbohydrates and added sugars has drastically increased over time, specifically as dietary percentage of red meat and saturated fat has gone down while dietary percentage of vegetables and vegetable oils has been on the rise. There are other complex factors that could be mentioned, but I’ll keep it simple.

The point is that the American population, in and outside of the military, are in compliance with official dietary recommendations. The military is even able to enforce a high-carb, low-fat diet on military personnel since they have few other choices when food is prepared for them, and it is specifically during deployment that military personnel have the worst diet-related health decline. There is no greater opportunity than the military for gathering highly-controlled dietary data, as the only other segment with more controlled diets are those locked away in institutions. Also, the military enforces a rigid exercise program, and those who join are those who self-selected for this lifestyle and then had to meet high standards to be accepted. Yet military personnel apparently are getting fatter and fatter.

The amount of carbohydrates we’re talking about here is not insignificant. The USDA recommends 50-60% of the diet to consist of carbohydrates with an emphasis on grains, most of those simple starchy carbs. Even adding some fiber back into processed foods doesn’t really make them any healthier. Grains alone brings up a whole mess of other issues besides gluten (e.g., grains block absorption of certain key nutrients) — it’s long been known that the best way of fattening animals is with grains.

To put in context how distorted is our diet, a recent study compared a high-carb and a low-carb diet where the latter consisted of 40% carbs. If that is what goes for low-carb these days, no wonder we are such a sickly population. Most traditional societies rarely get such high levels of carbs and what they do get usually comes from sources that are fibrous and nutrient-dense. Look at hunter-gatherers — 40% carbs would be at the extreme high end with many groups only getting 22% carbs. As a concrete example, compared to potato chips or a baked potato, chewing on a fibrous wild tuber is a laborious process because of how tough it is, only gaining slightly more calories than you’d be expending for all the effort.

For further perspective, a study published this month implemented a ketogenic diet (Richard A. LaFountain et al, Extended Ketogenic Diet and Physical Training Intervention in Military Personnel). That by itself isn’t noteworthy, as ketosis has been scientifically studied for about a century. What is significant is that it was the first time that such a diet done was done with military personnel. If you’re familiar with this area of research, the results were predictable which is to say they were typical. Military personnel aren’t essentially any different than other demographics. We all evolved from the same ancestors with the same metabolic system.

The results were positive as expected. Health improved in all ways measured. Body fat, in particular, was lost — relevant because the subjects were overweight. Benefits were seen in other aspects of what is called metabolic syndrome, such as better insulin sensitivity. All of this was accomplished while physical fitness was maintained, an important factor for the military. Going by what we know, if anything, physical fitness would improve over time; but that would require a longer term study to determine.

Ketosis is how I and millions of others have lost weight, even among those who don’t know what ketosis is. Anyone who has ever restricted their diet in any way, including fasting, likely has experienced extended periods of ketosis with no conscious intention being required — ketosis simply happens when carbs and sugar are restricted, and even commercial diets like Weight Watchers are quite restrictive along these lines. Other ketogenic gains often are experienced in relation to hunger, cravings, mood, energy, stamina, alertness, and focus. The point here, though, was weight loss and once again it was a glorious success.

That such studies are finally being done involving the military indicates that, after a century of research, government officials are maybe finally coming around to taking ketosis seriously. It’s understandable why drug companies and doctors have been resistant, since there is no profit in a healthy sustainable diet, but profit isn’t a concern for the military or shouldn’t be, although military contractors who provide the food might disagree (high-carb food is cheaper to provide because of high-yield crops subsidized for a half century by the government). If the USDA won’t change its guidelines, maybe the military should develop its own. A military filled with those of less than optimal health is a national security threat.

As for the rest of us, maybe it’s time we look to the studies and make informed decisions for ourselves. Not many doctors know about this kind of research. And if anything, doctors have a misinformed fear about ketosis because of confusion with diabetic ketoacidosis. Doctors aren’t exactly the most knowledgeable group when it comes to nutrition, as many have noted. And the government is too tied up with agricultural and food corporations. Any positive changes will have to come from the bottom up. These changes are already happening in a growing movement in support of alternative diets such as ketogenic low-carb, which is maybe what brought it to the attention of some military officials.

Government will eventually come around out of necessity. A global superpower can’t maintain itself in the long run with a malnourished and obese population. The healthcare costs and lost sick days alone could cripple society — even now most of the healthcare costs go to a few preventable diseases like diabetes. I’m willing to bet that when the next world war is fought the soldiers will be eating low-carb, high-fat rations made with nutrient-dense ingredients. Not doing so would risk having an inferior military. For-profit ideology only goes so far when the stakes are high.

* * *

Is U.S. Nutrition Policy Making the Military (and Recruits) too Fat to Fight?
from Nutrition Coalition

This year, for the first time since 2005, the Army fell short of its recruitment goal, according to the recent report, “Unhealthy and Unprepared,” by The Council for a Strong America, a group of retired generals and admirals. Obesity was largely to blame. Some 71% of young people between the ages of 17 and 24 fail to qualify for military service, says the report. These alarming numbers raise the disturbing question of whether the U.S. will be able to continue the luxury of maintaining an all-volunteer army in the future.

Another recent study, this one by the Rand Corporation found that some two-thirds of the nation’s active military personnel are overweight or obese. Topping the scale is the Army, with 69.4% of its personnel overweight or obese. But even the trimmest military branch – the Marine Corps – isn’t much better, at 60.9%. These numbers may be misleading, since “obesity” is defined by BMI (body mass index), which does not distinguish between whether extra pounds come fat or muscle—the latter being more likely to be the case in the military. Still, rates of 60-69% are disturbingly high. Since these folks are following the military’s exercise program, we certainly can’t blame them for shirking on physical activity.

It seems, in fact, that the U.S. military diet actually worsens health, according to an Army publication six years ago. Chanel S. Weaver of the U.S. Army Public Health Command wrote, “Even those Soldiers who are actually fit enough to deploy can face challenges in maintaining a healthy weight while serving in the deployed environment.”

In the article, Dr. Theresa Jackson, a public health scientist at the U.S. Army Public Health Command, states, “Literature suggests that fitness decreases and fat mass increases during deployments.” This is an astonishing fact: fitness declines in the military, despite mandated regular exercise.

This paradox could be explained by the growing understanding that exercise plays a relatively minor role in weight loss. “You can’t exercise your way out of a bad diet,” is the new common catchphrase among experts. Instead, the principal factor driving obesity, as the data increasingly show, is poor nutrition.

A look at the Army’s nutrition guidelines shows that they emphasize low-fat, high-carbohydrate foods. The Army recommends eating “…high protein, low-fat items such as: fish, beans, whole wheat pasta, egg whites, skim or 1 percent milk, and low-fat yogurt” while avoiding “items such as: fried items, high fat meats, egg yolks, and whole milk.” This guidance comes from the U.S. Dietary Guidelines for Americans (DGA), a policy that has been co-issued by USDA and US-HHS since 1980. The military essentially downloads these guidelines and serves food in mess halls to reflect DGA recommendations.

Ironically, this reliance on the U.S. Guidelines could well be the very reason for the military’s obesity problems. This diet tells the entire U.S. population to eat 50-60% of their calories as carbohydrates, principally grains, and just as a high-grain diet fattens cattle, a large body of government-funded science shows that a high-carbohydrate diet, for most people, is inimical to sustainable weight loss.

The argument that Americans don’t follow the guidelines is not supported by the best available government data on this subject—which demonstrates widespread adherence to the Dietary Guidelines.

New military study: “Remarkable” results among soldiers on a ketogenic diet
by Anne Mullens and Bret Scher

Those on the ketogenic diet lost an average of 17 pounds (7.5 kg), 5 percent of their overall body fat, 44 percent of their visceral fat, and had their insulin sensitivity improve by 48 per cent. There was no change in the participants on the mixed diet. Training results in physical strength, agility, and endurance in both groups were similar.

The researchers noted:

The most striking result was consistent loss of body mass, fat mass, visceral fat, and enhanced insulin sensitivity in virtually all the ketogenic diet subjects despite no limitations on caloric intake. Physical performance was maintained…. These results are highly relevant considering the obesity problem affecting all branches of the military.

[…] Although neither group counted calories, the ketogenic diet group naturally reduced their caloric intake while eating to satiety.

The most noteworthy response was a spontaneous reduction in energy intake, resulting in a uniformly greater weight loss for all ketogenic diet participants.

The military should lead the U.S. fight against obesity
by Steve Barrons

That advice, driven by the government’s Dietary Guidelines for Americans, has largely stuck to the familiar low-fat, high-carbohydrate diet that calls on us to cut meat, butter and cheese. Yet in recent years, the science has evolved, and it has become increasingly clear to people like me that fats aren’t the enemy. Indeed, as I ate more fat and reduced my intake of sugars and other carbohydrates like grains, I lost weight and became healthier.

Experiences like mine are now backed by a fast-growing body of science, showing carbohydrate restriction to be effective for fighting obesity and diabetes while improving most heart-disease risk factors.

For many, it’s hard to get past the basic assumption that the fat on your plate becomes the fat in your body. But the truth is that it’s excessive carbohydrates that turn into body fat — completely contrary to what Americans have long been told.

So why hasn’t the government’s dietary advice caught up to the science? According to a rigorous investigation in The BMJ on the dietary guidelines, the experts appointed to review the scientific evidence relied on weak scientific standards in their report and failed to review the most recent science on a number of topics, including optimal intakes for carbohydrates, saturated fat and salt. Most critically, the report relied heavily on observational studies in which researchers follow test groups over long periods of time. But even the best epidemiological studies, according to the BMJ, “suffer from a fundamental limitation. At best they can show only association, not causation. Epidemiological data can be used to suggest hypotheses but not to prove them.” This is science 101.

The U.S. military serves more than 150 million meals per year to its personnel, and when those meals are based on a government-advised, high-carbohydrate diet, our troops have a harder time staying trim and healthy. The Army’s own website warns people to stay away from high-fat meats, egg yolks and whole milk and advises “eating less fatty food for better overall health,” while encouraging a diet that includes pasta and bread. Making matters worse, service members usually have fewer options for avoiding these nutritional mistakes, especially on deployments when they often can’t cook their own meals.

Pentagon eyes controversial diet in bid to build more lethal warriors
by Ben Wolfgang

Ditching carbs may be the key to military success in America’s future wars.

Top Pentagon officials say research has shown that human bodies in ketosis — the goal of the popular and controversial ketogenic diet — can stay underwater for longer periods, making the fat- and protein-heavy eating plan a potential benefit to military divers. It is one example of a rapidly growing trend as military researchers zero in on how nutrition and certain drugs can enhance how fighting men and women perform in battle. […]

But industries that specialize in the link between diet and performance are eager to engage in complex conversations about using cutting-edge science to optimize the human body while preserving basic elements of choice and individuality. The example of how ketosis — a biological process in which the body burns fat for fuel — could produce more capable military divers is one of the clearest examples of the 21st-century debate that now confronts the Pentagon.

“One of the effects of truly being in ketosis is that it changes the way your body handles oxygen deprivation, so you can actually stay underwater at [deeper] depths for longer periods of time and not go into oxygen seizures,” Lisa Sanders, director of science and technology at U.S. Special Operations Command, said at a high-level defense industry conference in Tampa late last month.

“That kind of technology is available today,” she said. “We can tell whether you are or are not in ketosis. We have really good indications of how to put you in ketosis. And we know statistically what that does to your ability to sustain oxygen.

“The problem,” she said, “is I don’t have the authority to tell people — swimmers, submariners, etc. — that they’re going to get themselves in ketosis so they can stay in the water longer. That’s an authority question, not a technology question.”

Defense Department to ban beer and pizza? Mandatory keto diet may enhance military performance
by Kristine Froeba

The controversial ketogenic or “keto” diet may be the future of the military, some defense officials say.

Service members, and Navy SEALS especially, may have to forgo beer and burritos for skinny cocktails and avocado salad (forget the tortilla chips) if a proposal from Special Operations Command gains momentum.

While a nutritionally enhanced future could eventually be put into effect for all branches, the SEALS and other underwater dive-mission specialists might be the first groups targeted for the change in nutritional guidelines. […]

Discussion of new dietary guidelines for service members comes at a time of growing concern about obesity in the military and its potential threat to readiness. […]

For the diet to be implemented laterally across the military, produce choices and meat quality at military dining facilities across the world would have to change significantly, not to mention the high-carb and sugar content of MRE’s. The popular pepperoni pizza MRE would be a thing of the past. Although one benefit of formulating a new high-fat ration is that it would be lighter weight to carry.

“You can carry even more calories because fats weigh less, which is an advantage,” said Kinesiologist Jeff Volek, a professor at Ohio State University’s Department of Human Sciences and author of the study.

* * *

Fasting, Calorie Restriction, and Ketosis

What we eat obviously affects gut health such as the microbiome and through that, along with other mechanisms, it affects the rest of our body, the brain included (by way of permeability, immune system, vagus nerve, substances like glutamate and propionate, and much else). About general health, I might add that foods eaten in what combination (e.g., red meat and grains) is also an issue. Opposite of what you eat impacting neurocognition and mental health, not eating (i.e., fasting, whether intermittent or extended) or else caloric restriction and carbohydrate reduction, ketogenic or otherwise, alters it in other ways.

Fasting, for example, increases the level of neurotransmitters such as serotonin, dopamine, and norepinephrine while temporarily reducing the brains release and use of them; plus, serotonin and its precursor tryptophan are made more available to the brain. So, it allows your reserves of neurotransmitters to rebuild to higher levels. That is partly why a ketogenic diet, along with the brains efficient use of ketones, shows improvements in behavior, learning, memory, acuity, focus, vigilance, and mood (such as sense of well-being and sometimes euphoria); with specific benefits, to take a couple of examples, in cerebral blood flow and prefrontal-cortex-related cognitive functions (mental flexibility and set shifting); while also promoting stress resistance, inflammation reduction, weight loss, and metabolism, and while decreasing free radical damage, blood pressure, heart rate, and glucose levels. Many of these are similar benefits as seen with strenuous exercise.

We know so much about this because the ketogenic diet is the only diet that has been specifically and primarily studied in terms of neurological diseases, going back to early 20th century research on epileptic seizures and autism, was shown effective for other conditions later in the century (e.g., V. A. Angelillo et al, Effects of low and high carbohydrate feedings in ambulatory patients with chronic obstructive pulmonary disease and chronic hypercapnia), and more recently with positive results seen in numerous other conditions (Dr. Terry Wahl’s work on multiple sclerosis, Dr. Dale Bredesen’s work on Alzheimer’s, etc). By the way, the direction of causality can also go the other way around, from brain to gut: “Studies also suggest that overwhelming systemic stress and inflammation—such as that induced via severe burn injury—can also produce characteristic acute changes in the gut microbiota within just one day of the sustained insult [15].” (Rasnik K. Singh et al, Influence of diet on the gut microbiome and implications for human health). And see:

“Various afferent or efferent pathways are involved in the MGB axis. Antibiotics, environmental and infectious agents, intestinal neurotransmitters/neuromodulators, sensory vagal fibers, cytokines, essential metabolites, all convey information about the intestinal state to the CNS. Conversely, the HPA axis, the CNS regulatory areas of satiety and neuropeptides released from sensory nerve fibers affect the gut microbiota composition directly or through nutrient availability. Such interactions appear to influence the pathogenesis of a number of disorders in which inflammation is implicated such as mood disorder, autism-spectrum disorders (ASDs), attention-deficit hypersensitivity disorder (ADHD), multiple sclerosis (MS) and obesity.” (Anastasia I. Petra et al, Gut-Microbiota-Brain Axis and Its Effect on Neuropsychiatric Disorders With Suspected Immune Dysregulation)

There are many other positive effects. Fasting reduces the risk of neurocognitive diseases: Parkinson’s, Alzheimer’s, etc. And it increases the protein BDNF (brain-derived neurotrophic factor) that helps grow neuronal connections. Results include increased growth of nerve cells from stem cells (as stem cells are brought out of their dormant state) and increased number of mitochondria in cells (mitochondria are the energy factories), the former related to the ability of neurons to develop and maintain connections between each other. An extended fast will result in autophagy (cellular housekeeping), the complete replacement of your immune cells and clearing out damaged cells which improves the functioning of your entire body (it used to be thought to not to occur in the brain but we now know it does) — all interventions known to prolong youthful health, lessen and delay diseases of aging (diabetes, cancer, cardiovascular disease, etc), and extend lifespan in lab animals involve autophagy (James H. Catterson et al, Short-Term, Intermittent Fasting Induces Long-Lasting Gut Health and TOR-Independent Lifespan Extension). Even calorie restriction has no effect when autophagy is blocked (Fight Aging!, Autophagy Required For Calorie Restriction Benefits?). It cleans out the system, gives the body a rest from its normal functioning, and redirects energy toward healing and rebuilding.

As a non-human example, consider hibernation for bears. A study was done comparing bears with a natural diet (fruits, nuts, insects, and small mammals) and those that ate human garbage (i.e., high-carb processed foods). “A research team tracked 30 black bears near Durango, Colo., between 2011 and 2015, paying close attention to their eating and hibernation habits. The researchers found that bears who foraged on human food hibernated less during the winters — sometimes, by as much as 50 days — than bears who ate a natural diet. The researchers aren’t sure why human food is causing bears to spend less time in their dens. But they say shorter hibernation periods are accelerating bears’ rates of cellular aging” (Megan Schmidt, Human Food Might Be Making Bears Age Faster). As with humans who don’t follow fasting or a ketogenic diet, bears who hibernate less don’t live as long. Maybe a high-carb diet messes with hibernation similarly to how it messes with ketosis.

Even intermittent fasting shows many of these benefits. Of course, you can do dramatic changes to the body without fasting at all, if you’re on a ketogenic diet (though one could call it a carb fast since it is extremely low carb) or severe caloric restriction (by the way, caloric restriction has been an area of much mixed results and hence confusion — see two pieces by Peter Attia: Calorie restriction: Part I – an introduction & Part IIA – monkey studies; does intermittent fasting and ketosis mimic caloric restriction or the other way around?). I’d add a caveat: On any form of dietary limitation or strict regimen, results vary depending on specifics of test subjects and other factors: how restricted and for how long, micronutrient and macronutrient content of diet, fat-adaptation and metabolic flexibility, etc; humans, by the way, are designed for food variety and so it is hard to know the consequences of modern diet that often remains unchanged, season to season, year to year (Rachel Feltman, The Gut’s Microbiome Changes Rapidly with Diet). There is a vast difference between someone on a high-carb diet doing an occasional fast and someone on a ketogenic diet doing regular intermittent fasting. Even within a single factor such as a high-carb diet, there is little similarity between the average American eating processed foods and a vegetarian monk eating restricted calories. As another example, autophagy can take several days of fasting to be fully achieved; but how quickly this happens depends on the starting conditions such as how many carbs eaten beforehand and how much glucose in the blood and glycogen stores in the muscles, both of which need to be used up before ketosis begins.

Metabolic flexibility, closely related to fat-adaptation, requires flexibility of the microbiome. Research has found that certain hunter-gatherers have microbiomes that completely switch from season to season and so the gut somehow manages to maintain some kind of memory of previous states of microbial balance which allows them to be re-established as needed. This is seen more dramatically with the Inuit who eat an extremely low-carb diet, but they seasonally eat relatively larger amounts of plant matter such as seaweed and they temporarily have digestive issues until the needed microbes take hold again. Are these microbes dormant in the system or systematically reintroduced? In either case, the process is unknown, as far as I know. What we are clear about is how dramatically diet affects the microbiome, whatever the precise mechanisms.

For example, a ketogenic diet modulates the levels of the microbes Akkermansia muciniphila, Lactobacillus, and Desulfovibrio (Lucille M. Yanckello, Diet Alters Gut Microbiome and Improves Brain Functions). It is the microbes that mediate the influence on both epileptic seizures and autism, such that Akkermansia is decreased in the former and increased in the latter, that is to say the ketogenic diet helps the gut regain balance no matter which direction the imabalance is. In the case of epileptic seizures, Akkermansia spurs the growth of Parabacteroides which alters neurotransmission by elevating the GABA/glutamate ratio (there is glutamate again): “the hippocampus of the microbe-protected mice had increased levels of the neurotransmitter GABA, which silences neurons, relative to glutamate, which activates them” (Carolyn Beans, Mouse microbiome findings offer insights into why a high-fat, low-carb diet helps epileptic children), but no such effect was found in germ-free mice, that is to say with no microbiome (similar results were found in human studies: Y. Zhang, Altered gut microbiome composition in children with refractory epilepsy after ketogenic diet). Besides reducing seizures, “GABA is a neurotransmitter that calms the body. Higher GABA to glutamate ratios has been shown to alleviate depression, reduce anxiety levels, lessen insomnia, reduce the severity of PMS symptoms, increase growth hormone, improve focus, and reduce systemic inflammation” (MTHFR Support, Can Eating A Ketogenic Diet Change Our Microbiome?). To throw out the other interesting mechanism, consider Desulfovibrio. Ketosis reduces its numbers and that is a good thing since it causes leakiness of the gut barrier, and what causes leakiness in one part of the body can cause it elsewhere as well such as the brain barrier. Autoimmune responses and inflammation can follow. This is why ketosis has been found beneficial for preventing and treating neurodegenerative conditions like Alzheimer’s (plus, ketones are a useful alternative fuel for Alzheimer’s since their brain cells begin starving to death for loss of the capacity to use glucose as a fuel).

All of this involves the factors that increase and reduce inflammation: “KD also increased the relative abundance of putatively beneficial gut microbiota (Akkermansia muciniphila and Lactobacillus), and reduced that of putatively pro-inflammatory taxa (Desulfovibrio and Turicibacter).” (David Ma et al, Ketogenic diet enhances neurovascular function with altered gut microbiome in young healthy mice). Besides the microbiome itself, this has immense impact on leakiness and autoimmune conditions, with this allowing inflammation to show up in numerous areas of the body, including the brain of course. Inflammation is found in conditions such as depression and schizophrenia. Even without knowing this mechanism, much earlier research has long established that ketosis reduces inflammation.

It’s hard to know what this means, though. Hunter-gatherers tend to have much more diverse microbiomes, as compared to industrialized people. Yet the ketogenic diet that helps induce microbial balance simultaneously reduces diversity. So, diversity isn’t always a good thing, with another example being small intestinal bacterial overgrowth (SIBO). What matters is which microbes one has in abundance and in relation which microbes one lacks or has limitedly. And what determines that isn’t limited to diet in the simple sense of what foods we eat or don’t eat but the whole pattern involved. Also, keep in mind that in a society like ours most of the population is in varying states of gut dysbiosis. First eliminating the harmful microbes is most important before the body can heal and rebalance. That is indicated by a study on multiple sclerosis that found, after the subjects had an initial reduction in the microbiome, “They started to recover at week 12 and exceeded significantly the baseline values after 23–24 weeks on the ketogenic diet” (Alexander Swidsinski et al, Reduced Mass and Diversity of the Colonic Microbiome in Patients with Multiple Sclerosis and Their Improvement with Ketogenic Diet). As always, it’s complex. But the body knows what to do when you give it the tools its evolutionarily-adapted to.

In any case, all of the methods described can show a wide range of benefits and improvements in physical and mental health. They are potentially recommended for almost anyone who is in a healthy state or in some cases of disease, although as always seek medical advice before beginning any major dietary change, especially anyone with an eating disorder or malnourishment (admittedly, almost all people on a modern industrialized diet are to some degree malnourished, especially Americans, although most not to a degree of being immediately life-threatening). Proceed with caution. But you are free to take your life in your hands by taking responsibility for your own health through experimentation in finding out what happens (my preferred methodology), in which case the best case scenario is that you might gain benefit at no professional medical cost and the worst case scenario is that you might die (not that I’ve heard of anyone dying from a typical version of a diet involving fasting, ketosis, and such; you’re way more likely to die from the standard American diet; but individual health conditions aren’t necessarily predictable based on the experience of others, even the vast majority of others). Still, you’re going to die eventually, no matter what you do. I wish you well, until that time.

* * *

Let me clarify one point of widespread confusion. Talk of ‘diets’, especially of the variety I’ve discussed here, are often thought of in terms of restriction and that word does come up quite a bit. I’m guilty of talking this way even in this post, as it is about impossible to avoid such language considering it is used in the scientific and medical literature. So, there is an implication of deprivation, of self-control and self-denial, as if we must struggle and suffer to be healthy. That couldn’t be further from the truth.

Once you are fat-adapted and have metabolic flexibility, you are less restricted than you were before, in that you can eat more carbs and sugars for a time and then more easily return back to ketosis, as is a common seasonal pattern for hunter-gatherers. And once you no longer are driven by food cravings and addictions, you’ll have a happier and healthier relationship to food — eating when genuinely hungry and going without for periods without irritation or weakness, as also is common among hunter-gatherers.

This is simply a return to the state in which most humans have existed for most of our historical and evolutionary past. It’s not restriction or deprivation, much less malnourishment. It’s normalcy or should be. But we need to remember what normalcy looks and feels like: “People around the world suffer from starvation and malnutrition, and it is not only because they lack food and nutrients. Instead they suffer from immature microbiomes, which can severely impact health” (AMI, The effects of fasting and starvation on the microbiome). Gut health is inseparable from the rest, and these diets heal and rebalance the gut.

We need to redefine what health means, in a society where sickness has become the norm.

* * *

Here is a good discussion that is relevant here, even though the author never discusses ketosis anywhere in his book. He is pointing out that calorie intake and energy usage is approximately the same for urbanized humans as for hunter-gatherers. Yet the former have higher rates of obesity and the latter don’t. As many have noted, not all calories are the same and so calories-in/calories-out is a myth. This data makes more sense once you understand how profoundly different the body functions under ketogenic and non-ketogenic states.

100 Million Years of Food
by Stephen Le
pp.166 -168

At this point, a reader might conclude that the root of modern food-related ailments like obesity and diabetes lies in people eating a lot more food, due to the miracle of nitrogen fixation, and doing a lot less physical activity, due to the miracle of combustion engines and private vehicles. However, it turns out that neither of these common beliefs is supported by the evidence.

First, the food intake myth. The daily energy consumed through food in contemporary industrialized nations runs from about 2,300 kcal (kilocalories) among Japanese men and 1,800 kcal among Japanese women to 2,600 kcal among American men and 1,900 kcal among American women. 21 What is surprising is that the average daily caloric intake of these overweight industrialized societies is about the same as among hunter-gatherer groups, with some hunter-gatherer groups below and others above the calories consumed of industrialized nations. 22 Although hunter-gatherers ate about as much as we do today, they faced much greater variability in their food supply. In northern Australia, among the Anbarra, the daily energy intake dropped to 1,600 kcal during the rainy season and peaked at 2,500 kcal during the dry season. The calorie consumption of the Hiwi in the rainforests of Venezuela bounced between 1,400 and 2,800 kilocalories, depending on the season (plant foods were most plentiful at the end of the wet season). Thus, if any major pattern emerges in terms of caloric intake, it is that our hunter-gatherer ancestors lived on a dramatically varying diet, which swung between feast and famine according to the season and other hazards of fortune.

Another surprising finding concerns physical activity. Although it is commonly believed that people in hunter-gatherer societies expended much more energy than people in industrialized societies today, the evidence so far does not support this assumption. One common measure of physical activity level (PAL) expresses the total energy used in one day as a multiple of a person’s metabolic rate. For example, a PAL of 1 means that a person uses only his/her metabolic energy, i.e., the energy expended by breathing, thinking, digesting, etc. A PAL of 2 means that a person uses twice as much energy as his or her base metabolic rate. PAL allows us to adjust for the fact that people have varying levels of metabolism; a person who has a high metabolic rate can burn up a lot of energy by just sitting in one place compared to a person with low metabolism, so a good measure of physical activity needs to compensate for differences in metabolism. To determine the amount of energy used in a day, the best measure involves giving a person a drink of water that has been “tagged” with isotopes of hydrogen and oxygen. Measurement of these two tags in samples of saliva, urine, or blood allows measurement of exhaled carbon dioxide and hence the degree of respiration from metabolic processes.

Using tagged water, the average PAL among foragers was found to be 1.78 for men and 1.72 for women. Among industrialized contemporary societies with a high human development index (which measures income, literacy, and so on), the PAL of men was 1.79 for men and 1.71 for women. 23 In other words, the energy expenditure of overweight contemporary industrialized societies is roughly the same as that of lean hunter-gatherer societies once metabolism is taken into account; or to put it another way, the cause of obesity is unlikely to be lack of exercise, because people in industrialized societies today use about the same amount of energy as people in hunter-gatherer societies. 24

This finding has important implications for understanding obesity. All of us living in industrialized societies are aware of the stigma associated with obesity, and perhaps the longer-term health consequences of diabetes, high blood pressure, gout, and cancers associated with being overweight. Since food intake and energy expenditure levels today are roughly the same as during ancestral times (using the lifestyles of modern hunter-gatherers as a reasonable model for our ancestors’ lifestyles), why are obesity and diabetes so prevalent among industrialized societies and virtually nonexistent among our ancestors?

The first argument might be an objection that obesity has in fact been with us since the days of our earliest ancestors, so nothing has changed. It has been suggested that figurines of markedly obese women, found in Europe and dating to thirty thousand years ago, are proof that obesity existed at that time. However, no hunter-gatherer or small-scale horticultural group has ever manifested signs of obesity, despite having caloric intake and energy expenditure (adjusted for metabolism) within the range of contemporary industrialized populations. Thus the prehistoric statuettes may be representative of idealized feminine beauty, just as Barbie dolls and Japanese anime characters with huge eyes and exaggerated busts are fantasies more revealing of their creators than of real women.

* * *

Genius Foods:
Become Smarter, Happier, and More Productive While Protecting Your Brain for Life
by Max Lugavere

Baby Fat Isn’t Just Cute—It’s a Battery

Have you seen a baby lately? I’m talking about a newborn, fresh out of the womb. They’re fat. And cute. But mostly fat. Packed with stored energy prior to birth in the third trimester, the fatness of human babies is unprecedented in the mammal world. While the newborns of most mammal species average 2 to 3 percent of birth weight as body fat, humans are born with a body fat percentage of nearly 15, surpassing the fatness of even newborn seals. Why is this so? Because humans are born half-baked.

When a healthy human baby emerges from the womb, she is born physically helpless ad with an underdeveloped brain. Unlike most animals at birth, a newborn human is not equipped with a full catalogue of instincts preinstalled. It is estimated that if a human were to be born at a similar stage of cognitive development to a newborn chimp, gestation would be at least double the length (that doesn’t sound fun—am I right ladies?). By being born “prematurely,” human brains complete their development not in the womb, but in the real world, with open eyes and open ears—this is probably why we’re so social and smart! And it is during this period for rapid brain growth, what some refer to as the “fourth trimester,” that our fast serves as an important ketone reservoir for the brain, which can account for nearly 90 percent of the newborn’s metabolism. Now you know: baby fat isn’t just there for pinching. It’s there for the brain.

* * *

Mitochondria and the Future of Medicine:
The Key to Understanding Disease, Chronic Illness, Aging, and Life Itself
by Lee Know

Ketogenic Diets and Calorie Restriction

Ketone bodies, herein also referred to simply as ketones , are three water-soluble compounds that are produced as by-products when fatty acids are broken down for energy in the liver. These ketones can be used as a source of energy themselves, especially in the heart and brain, where they are a vital source of energy during periods of fasting.

The three endogenous ketones produced by the body are acetone , acetoacetic acid , and beta-hydroxybutyric acid (which is the only one that’s not technically a ketone, chemically speaking). They can be converted to acetyl-CoA, which then enters the TCA cycle to produce energy.

Fatty acids are so dense in energy, and the heart is one of the most energy-intensive organs, so under normal physiologic conditions, it preferentially uses fatty acids as its fuel source. However, under ketotic conditions, the heart can effectively utilize ketone bodies for energy.

The brain is also extremely energy-intensive, and usually relies on glucose for its energy. However, when glucose is in short supply, it gets a portion of its energy from ketone bodies (e.g., during fasting, strenuous exercise, low-carbohydrate, ketogenic diet, and in neonates). While most other tissues have alternate fuel sources (besides ketone bodies) when blood glucose is low, the brain does not. For the brain, this is when ketones become essential. After three days of low blood glucose, the brain gets 25 percent of its energy from ketone bodies. After about four days, this jumps to 70 percent!

In normal healthy individuals, there is a constant production of ketone bodies by the liver and utilization by other tissues. Their excretion in urine is normally very low and undetectable by routine urine tests. However, as blood glucose falls, the synthesis of ketones increases, and when it exceeds the rate of utilization, their blood concentration increases, followed by increased excretion in urine. This state is commonly referred to as ketosis , and the sweet, fruity smell of acetone in the breath is a common feature of ketosis.

Historically, this sweet smell was linked to diabetes and ketones were first discovered in the urine of diabetic patients in the mid-nineteenth century. For almost fifty years thereafter, they were thought to be abnormal and undesirable by-products of incomplete fat oxidation.

In the early twentieth century, however, they were recognized as normal circulating metabolites produced by the liver and readily utilized by the body’s tissues. In the 1920s, a drastic “hyperketogenic” diet was found to be remarkably effective for treating drug-resistant epilepsy in children. In 1967, circulating ketones were discovered to replace glucose as the brain’s major fuel during prolonged fasting. Until then, the adult human brain was thought to be entirely dependent upon glucose.

During the 1990s, diet-induced hyperketonemia (commonly called nutritional ketosis ) was found to be therapeutically effective for treating several rare genetic disorders involving impaired glucose utilization by nerve cells. Now, growing evidence suggests that mitochondrial dysfunction and reduced bioenergetic efficiency occur in brains of patients with Parkinson’s disease and Alzheimer’s disease. Since ketones are efficiently used by brain mitochondria for ATP generation and might also help protect vulnerable neurons from free-radical damage, ketogenic diets are being evaluated for their ability to benefit patients with Parkinson’s and Alzheimer’s diseases, and various other neurodegenerative disorders (with some cases reporting remarkable success).

There are various ways to induce ketosis, some easier than others. The best way is to use one of the various ketogenic diets (e.g., classic, modified Atkins, MCT or coconut oil, low-glycemic index diet), but calorie restriction is also proving its ability to achieve the same end results when carbohydrates are limited.

Features of Caloric Restriction

There are a number of important pieces to caloric restriction. First, and the most obvious, is that caloric intake is most critical. Typically, calories are restricted to about 40 percent of what a person would consume if food intake was unrestricted. For mice and rats, calorie restriction to this degree results in very different physical characteristics (size and body composition) than those of their control-fed counterparts. Regarding life extension, even smaller levels of caloric restriction (a reduction of only 10–20 percent of unrestricted calorie intake) produce longer-lived animals and disease-prevention effects.

In April of 2014, a twenty-five-year longitudinal study on rhesus monkeys showed positive results. The benefit of this study was that it was a long-term study done in primates—human’s closest relatives—and confirms positive data we previously saw from yeasts, insects, and rodents. The research team reported that monkeys in the control group (allowed to eat as much as they wanted) had a 2.9-fold increased risk of disease (e.g., diabetes) and a 3-fold increased risk of premature death, compared to calorie-restricted monkeys (that consumed a diet with 30 percent less calories).

If other data from studies on yeast, insects, and rodents can be confirmed in primates, it would indicate that calorie restriction could extend life span by up to 60 percent, making a human life span of 130–150 years a real possibility without fancy technology or supplements or medications. The clear inverse relationship between energy intake and longevity links its mechanism to mitochondria—energy metabolism and free-radical production.

Second, simply restricting the intake of fat, protein, or carbohydrates without overall calorie reduction does not increase the maximum life span of rodents. It’s the calories that count, not necessarily the type of calories (with the exception of those trying to reach ketosis, where type of calorie does count).

Third, calorie restriction has been shown to be effective in disease prevention and longevity in diverse species. Although most caloric restriction studies have been conducted on small mammals like rats or mice, caloric restriction also extends life span in single-celled protozoans, water fleas, fruit flies, spiders, and fish. It’s the only method of life extension that consistently achieves similar results across various species.

Fourth, these calorie-restricted animals stay “biologically younger” longer. Experimental mice and rats extended their youth and delayed (even prevented) most major diseases (e.g., cancers, cardiovascular diseases). About 90 percent of the age-related illnesses studied remained in a “younger” state for a longer period in calorie-restricted animals. Calorie restriction also greatly delayed cancers (including breast, colon, prostate, lymphoma), renal diseases, diabetes, hypertension, hyperlipidemia, lupus, and autoimmune hemolytic anemia, and a number of others.

Fifth, calorie restriction does not need to be started in early age to reap its benefits. Initiating it in middle-aged animals also slowed aging (this is good news for humans, because middle age is when most of us begin to think about our own health and longevity).

Of course, the benefits of calorie restriction relate back to mitochondria. Fewer calories mean less “fuel” (as electrons) entering the ETC, and a corresponding reduction in free radicals. As you know by now, that’s a good thing.

Health Benefits

As just discussed, new research is showing that judicious calorie restriction and ketogenic diets (while preserving optimal nutritional intake) might slow down the normal aging process and, in turn, boost cardiovascular, brain, and cellular health. But how? We can theorize that the restriction results in fewer free radicals, but one step in confirming a theory is finding its mechanism.

In particular, researchers have identified the beneficial role of beta-hydroxybutyric acid (the one ketone body that’s not actually a ketone). It is produced by a low-calorie diet and might be the key to the reduced risk of age-related diseases seen with calorie restriction. Over the years, studies have found that restricting calories slows aging and increases longevity, but the mechanism behind this remained elusive. New studies are showing that beta-hydroxybutyric acid can block a class of enzymes, called histone deacetylases , which would otherwise promote free-radical damage.

While additional studies need to be conducted, it is known that those following calorie-restricted or ketogenic diets have lower blood pressure, heart rate, and glucose levels than the general population. More recently, there has been a lot of excitement around intermittent fasting as an abbreviated method of achieving the same end results.

However, self-prescribing a calorie-restricted or ketogenic diet is not recommended unless you’ve done a lot of research on the topic and know what to do. If not done properly, these diets can potentially increase mental and physical stress on the body. Health status should be improving, not declining, as a result of these types of diets, and when not done properly, these diets could lead to malnutrition and starvation. Health care practitioners also need to properly differentiate a patient who is in a deficiency state of anorexia or bulimia versus someone in a healthy state of ketosis or caloric restriction.

I’ll add a final word of caution: While ketogenic diets can be indispensable tools in treating certain diseases, their use in the presence of mitochondrial disease—at this point—is controversial and depends on the individual’s specific mitochondrial disease. In some cases, a ketogenic diet can help; in others it can be deleterious. So, of all the therapies listed in this book, the one for which I recommend specific expertise in its application is this diet, and only after a proper diagnosis.

* * *

Grain Brain:
The Surprising Truth about Wheat, Carbs, and Sugar–Your Brain’s Silent Killers

by David Perlmutter

Caloric Restriction

Another epigenetic factor that turns on the gene for BDNF production is calorie restriction. Extensive studies have clearly demonstrated that when animals are on a reduced-calorie diet (typically reduced by around 30 percent), their brain production of BDNF shoots up and they show dramatic improvements in memory and other cognitive functions. But it’s one thing to read experimental research studies involving rats in a controlled environment and quite another to make recommendations to people based upon animal research. Fortunately, we finally have ample human studies demonstrating the powerful effect of reducing caloric intake on brain function, and many of these studies have been published in our most well-respected medical journals. 13

In January 2009, for example, the Proceedings of the National Academy of Science published a study in which German researchers compared two groups of elderly individuals—one that reduced their calories by 30 percent and another that was allowed to eat whatever they wanted. The researchers were interested in whether changes could be measured between the two groups’ memory function. At the conclusion of the three-month study, those who were free to eat without restriction experienced a small but clearly defined decline in memory function, while memory function in the group on the reduced-calorie diet actually increased, and significantly so. Knowing that current pharmaceutical approaches to brain health are very limited, the authors concluded, “The present findings may help to develop new prevention and treatment strategies for maintaining cognitive health into old age.” 14

Further evidence supporting the role of calorie restriction in strengthening the brain and providing more resistance to degenerative disease comes from Dr. Mark P. Mattson, chief of the Laboratory of Neurosciences at the National Institute on Aging (NIA). He reported:

Epidemiological data suggest that individuals with a low calorie intake may have a reduced risk of stroke and neurodegenerative disorders. There is a strong correlation between per capita food consumption and risk for Alzheimer’s disease and stroke. Data from population-based case control studies showed that individuals with the lowest daily calorie intakes had the lowest risk of Alzheimer’s disease and Parkinson’s disease. 15

Mattson was referring to a population-based longitudinal prospective study of Nigerian families, in which some members moved to the United States. Many people believe that Alzheimer’s disease is something you “get” from your DNA, but this particular study told a different story. It was shown that the incidence of Alzheimer’s disease among Nigerian immigrants living in the United States was increased compared to their relatives who remained in Nigeria. Genetically, the Nigerians who moved to America were the same as their relatives who remained in Nigeria. 16 All that changed was their environment—specifically, their caloric intake. The research clearly focused on the detrimental effects that a higher caloric consumption has on brain health. In a 2016 study published in Johns Hopkins Health Review, Mattson again emphasized the value of caloric restriction in warding off neurodegenerative diseases while at the same time improving memory and mood. 17 One way to do that is through intermittent fasting, which we’ll fully explore in chapter 7 . Another way, obviously, is to trim back your daily consumption.

If the prospect of reducing your calorie intake by 30 percent seems daunting, consider the following: On average, we consume 23 percent more calories a day than we did in 1970. 18 Based on data from the Food and Agriculture Organization of the United Nations, the average American adult consumes more than 3,600 calories daily. 19 Most would consider “normal” calorie consumption to be around 2,000 calories daily for women and 2,500 for men (with higher requirements depending on level of activity/exercise). A 30 percent cut of calories from an average of 3,600 per day equals 1,080 calories.

We owe a lot of our increased calorie consumption to sugar. Remember, the average American consumes roughly 163 grams (652 calories) of refined sugars a day—reflecting upward of a 30 percent hike in just the last three decades. 20 And of that amount, about 76 grams (302 calories) are from high-fructose corn syrup. So focusing on just reducing sugar intake may go a long way toward achieving a meaningful reduction in calorie intake, and this would obviously help with weight loss. Indeed, obesity is associated with reduced levels of BDNF, as is elevation of blood sugar. Remember, too, that increasing BDNF provides the added benefit of actually reducing appetite. I call that a double bonus.

But if the figures above still aren’t enough to motivate you toward a diet destined to help your brain, in many respects, the same pathway that turns on BDNF production can be activated by intermittent fasting (which, again, I’ll detail in chapter 7 ).

The beneficial effects in treating neurologic conditions using caloric restriction actually aren’t news for modern science, though; they have been recognized since antiquity. Calorie restriction was the first effective treatment in medical history for epileptic seizures. But now we know how and why it’s so effective: It confers neuroprotection, increases the growth of new brain cells, and allows existing neural networks to expand their sphere of influence (i.e., neuroplasticity).

While low caloric intake is well documented in relation to promoting longevity in a variety of species—including roundworms, rodents, and monkeys—research has also demonstrated that lower caloric intake is associated with a decreased incidence of Alzheimer’s and Parkinson’s disease. And the mechanisms by which we think this happens are via improved mitochondrial function and controlling gene expression.

Consuming fewer calories decreases the generation of free radicals while at the same time enhancing energy production from the mitochondria, the tiny organelles in our cells that generate chemical energy in the form of ATP (adenosine triphosphate). Mitochondria have their own DNA, and we know now that they play a key role in degenerative diseases such as Alzheimer’s and cancer. Caloric restriction also has a dramatic effect on reducing apoptosis, the process by which cells undergo self-destruction. Apoptosis happens when genetic mechanisms within cells are turned on that culminate in the death of that cell. While it may seem puzzling at first as to why this should be looked upon as a positive event, apoptosis is a critical cellular function for life as we know it. Pre-programmed cell death is a normal and vital part of all living tissues, but a balance must be struck between effective and destructive apoptosis. In addition, caloric restriction triggers a decrease in inflammatory factors and an increase in neuroprotective factors, specifically BDNF. It also has been demonstrated to increase the body’s natural antioxidant defenses by boosting enzymes and molecules that are important in quenching excessive free radicals.

In 2008, Dr. Veronica Araya of the University of Chile in Santiago reported on a study she performed during which she placed overweight and obese subjects on a three-month calorie-restricted diet, with a total reduction of 25 percent of calories. 21 She and her colleagues measured an exceptional increase in BDNF production, which led to notable reductions in appetite. It’s also been shown that the opposite occurs: BDNF production is decreased in animals on a diet high in sugar. 22 Findings like this have since been replicated.

One of the most well-studied molecules associated with caloric restriction and the growth of new brain cells is sirtuin-1 (SIRT1), an enzyme that regulates gene expression. In monkeys, increased SIRT1 activation enhances an enzyme that degrades amyloid—the starch-like protein whose accumulation is the hallmark of diseases like Alzheimer’s. 23 In addition, SIRT1 activation changes certain receptors on cells, leading to reactions that have the overall effect of reducing inflammation. Perhaps most important, activation of the sirtuin pathway by caloric restriction enhances BDNF. BDNF not only increases the number of brain cells, but also enhances their differentiation into functional neurons (again, because of caloric restriction). For this reason, we say that BDNF enhances learning and memory. 24

The Benefits of a Ketogenic Diet

While caloric restriction is able to activate these diverse pathways, which are not only protective of the brain but enhance the growth of new neuronal networks, the same pathway can be activated by the consumption of special fats called ketones. By far the most important fat for brain energy utilization is beta-hydroxybutyrate (beta-HBA), and we’ll explore this unique fat in more detail in the next chapter. This is why the so-called ketogenic diet has been a treatment for epilepsy since the early 1920s and is now being reevaluated as a therapeutic option in the treatment of Parkinson’s disease, Alzheimer’s disease, ALS, depression, and even cancer and autism. 25 It’s also showing promise for weight loss and ending type 2 diabetes. In mice models, the diet rescues hippocampal memory deficits, and extends healthy lifespan.

Google the term “ketogenic diet” and well over a million results pop up. Between 2015 and 2017, Google searches for the term “keto” increased ninefold. But the studies demonstrating a ketogenic diet’s power date back further. In one 2005 study, for example, Parkinson’s patients actually had a notable improvement in symptoms that rivaled medications and even brain surgery after being on a ketogenic diet for just twenty-eight days. 26 Specifically, consuming ketogenic fats (i.e., medium-chain triglycerides, or MCT oil) has been shown to impart significant improvement in cognitive function in Alzheimer’s patients. 27 Coconut oil, from which we derive MCTs, is a rich source of an important precursor molecule for beta-hydroxybutyrate and is a helpful approach to treating Alzheimer’s disease. 28 A ketogenic diet has also been shown to reduce amyloid in the brain, 29 and it increases glutathione, the body’s natural brain-protective antioxidant, in the hippocampus. 30 What’s more, it stimulates the growth of mitochondria and thus increases metabolic efficiency. 31

Dominic D’Agostino is a researcher in neuroscience, molecular pharmacology, and physiology at the University of South Florida. He has written extensively on the benefits of a ketogenic diet, and in my Empowering Neurologist interview with him he stated: “Research shows that ketones are powerful energy substrates for the brain and protect the brain by enhancing antioxidant defenses while suppressing inflammation. No doubt, this is why nutritional ketosis is something pharmaceutical companies are aggressively trying to replicate.” I have also done a lot of homework in understanding the brain benefits of ketosis—a metabolic state whereby the body burns fat for energy and creates ketones in the process. Put simply, your body is in a state of ketosis when it’s creating ketones for fuel instead of relying on glucose. And the brain loves it.

While science typically has looked at the liver as the main source of ketone production in human physiology, it is now recognized that the brain can also produce ketones in special cells called astrocytes. These ketone bodies are profoundly neuroprotective. They decrease free radical production in the brain, increase mitochondrial biogenesis, and stimulate production of brain-related antioxidants. Furthermore, ketones block the apoptotic pathway that would otherwise lead to self-destruction of brain cells.

Unfortunately, ketones have gotten a bad rap. I remember in my internship being awakened by a nurse to treat a patient in “diabetic ketoacidosis.” Physicians, medical students, and interns become fearful when challenged by a patient in such a state, and with good reason. It happens in insulin-dependent type 1 diabetics when not enough insulin is available to metabolize glucose for fuel. The body turns to fat, which produces these ketones in dangerously high quantities that become toxic as they accumulate in the blood. At the same time, there is a profound loss of bicarbonate, and this leads to significant lowering of the pH (acidosis). Typically, as a result, patients lose a lot of water due to their elevated blood sugars, and a medical emergency develops.

This condition is exceedingly rare, and again, it occurs in type 1 diabetics who fail to regulate their insulin levels. Our normal physiology has evolved to handle some level of ketones in the blood; in fact, we are fairly unique in this ability among our comrades in the animal kingdom, possibly because of our large brain-to-body weight ratio and the high energy requirements of our brain. At rest, 20 percent of our oxygen consumption is used by the brain, which represents only 2 percent of the human body. In evolutionary terms, the ability to use ketones as fuel when blood sugar was exhausted and liver glycogen was no longer available (during starvation) became mandatory if we were to survive and continue hunting and gathering. Ketosis proved to be a critical step in human evolution, allowing us to persevere during times of food scarcity. To quote Gary Taubes, “In fact, we can define this mild ketosis as the normal state of human metabolism when we’re not eating the carbohydrates that didn’t exist in our diets for 99.9 percent of human history. As such, ketosis is arguably not just a natural condition but even a particularly healthful one.” 32

There is a relationship between ketosis and calorie restriction, and the two can pack a powerful punch in terms of enhancing brain health. When you restrict calories (and carbs in particular) while upping fat intake, you trigger ketosis and increase levels of ketones in the blood. In 2012, when researchers at the University of Cincinnati randomly assigned twenty-three older adults with mild cognitive impairment to either a high-carbohydrate or very low-carbohydrate diet for six weeks, they documented remarkable changes in the low-carb group. 33 They observed not only improved verbal memory performance but also reductions in weight, waist circumference, fasting glucose, and fasting insulin. Now here’s the important point: “Ketone levels were positively correlated with memory performance.”

German researchers back in 2009 demonstrated in fifty healthy, normal to overweight elderly individuals that when calories were restricted along with a 20 percent increase in dietary fat, there was a measurable increase in verbal memory scores. 34 Another small study, yes, but their findings were published in the respected Proceedings of the National Academy of Sciences and spurred further research like that of the 2012 experiment. These individuals, compared to those who did not restrict calories, demonstrated improvements in their insulin levels and decline in their C-reactive protein, the infamous marker of inflammation. As expected, the most pronounced improvements were in people who adhered the most to the dietary challenge.

Research and interest in ketosis have exploded in recent years and will continue. The key to achieving ketosis, as we’ll see later in detail, is to severely cut carbs and increase dietary fat. It’s that simple. You have to be carb restricted if you want to reach this brain-blissful state.

* * *

Power Up Your Brain
by David Perlmutter and Alberto Villoldo

Your Brain’s Evolutionary Advantage

One of the most important features distinguishing humans from all other mammals is the size of our brain in proportion to the rest of our body. while it is certainly true that other mammals have larger brains, scientists recognize that larger animals must have larger brains simply to control their larger bodies. An elephant, for example, has a brain that weighs 7,500 grams, far larger than our 1,400-gram brain. So making comparisons about “brain power” or intelligence just based on brain size is obviously futile, Again, it’s the ratio of the brain size to total body size that attracts scientist’s interests when considering the brain’s functional capacity. An elephant’s brain represents 1/550 of its body weight, while the human brain weighs 1/40 of the total body weight. So our brain represents 2.5 percent of our total body weight as opposed to the large-brained elephant whose brain is just 0.18 percent of its total body weight.

But even more important than the fact that we are blessed with a lot of brain matter is the intriguing fact that, gram for gram, the human brain consumes a disproportionately huge amount of energy. While only representing 2.5 percent of our total body weight, the human brain consumes an incredible 22 percent of our body’s energy expenditure when at rest. this represents about 350 percent more energy consumption in relation to body weight compared with other anthropoids like gorillas, orangutans, and chimpanzees.

So it takes a lot of dietary calories to keep the human brain functioning. Fortunately, the very fact that we’ve developed such a large and powerful brain has provided us with the skills and intelligence to maintain adequate sustenance during times of scarcity and to make provisions for needed food supplies in the future. Indeed, the ability to conceive of and plan for the future is highly dependent upon the evolution not only of brain size but other unique aspects of the human brain.

It is a colorful image to conceptualize early Homo sapiens migrating across and arid plain and competing for survival among animals with smaller brains yet bigger claws and greater speed. But our earliest ancestors had one other powerful advantage compared to even our closest primate relatives. The human brain has developed a unique biochemical pathway that proves hugely advantageous during times of food scarcity. Unlike other mammals, our brain is able to utilize an alternative source of calories during times of starvation. Typically, we supply our brain with glucose form our daily food consumption. We continue to supply our brains with a steady stream of glucose (blood sugar) between meals by breaking down glycogen, a storage form of glucose primarily found in the liver and muscles.

But relying on glycogen stores provides only short-term availability of glucose. as glycogen stores are depleted, our metabolism shifts and we are actually able to create new molecules of glucose, a process aptly termed gluconeogenesis. this process involves the construction of new glucose molecules from amino acids harvested form the breakdown of protein primarily found in muscle. While gluconeogenesis adds needed glucose to the system, it does so at the cost of muscle breakdown, something less than favorable for a starving hunter-gatherer.

But human physiology offers one more pathway to provide vital fuel to the demanding brain during times of scarcity. When food is unavailable, after about three days the liver begins to use body fat to create chemicals called ketones. One ketone in particular, beta hydroxybutyrate (beta-HBA), actually serves as a highly efficient fuel source for the brain, allowing humans to function cognitively for extended periods during food scarcity.

Our unique ability to power our brains using this alternative fuel source helps reduce our dependence on gluconeogensis and therefore spares amino acids and the muscles they build and maintain. Reducing muscle breakdown provides obvious advantages for the hungry Homo sapiens in search of food. It is this unique ability to utilize beta-HBA as a brain fuel that sets us apart from our nearest animal relatives and has allowed humans to remain cognitively engaged and, therefore, more likely to survive the famines ever-present in our history.

This metabolic pathway, unique to Homo sapiens, may actually serve as an explanation for one of the most hotly debated questions in anthropology: what caused the disappearance of our Neanderthal relatives? Clearly, when it comes to brains, size does matter. Why then, with a brain some 20 percent larger than our own, did Neanderthals suddenly disappear in just a few thousand years between 40,000 and 30,000 years ago? the party line among scientists remains fixated on the notion that the demise of Neanderthals was a consequence of their hebetude, or mental lethargy. The neurobiologist William Calvin described Neanderthals in his book, A Brain for All Seasons: “Their way of life subjected them to more bone fractures; they seldom survived until forty years of age; and while making tools similar to [those of] overlapping species, there was little [of the] inventiveness that characterizes behaviorally modern Homo sapiens.”

While it is convenient and almost dogmatic to accept that Neanderthals were “wiped out” by clever Homo sapiens, many scientists now believe that food scarcity may have played a more prominent role in their disappearance. Perhaps the simple fact that Neanderthals, lacking the biochemical pathway to utilize beta-HBA as a fuel source for brain metabolism, lacked the “mental endurance” to persevere. Relying on gluconeogenesis to power their brains would have led to more rapid breakdown of muscle tissue, ultimately compromising their ability to stalk prey or migrate to areas where plant food sources were more readily available. their extinction may not have played out in direct combat with Homo sapiens but rather manifested as a consequence of a simple biochemical inadequacy.

Our ability to utilize beta-HBA as a brain fuel is far more important than simply a protective legacy of our hunter-gatherer heritage. George F. Cahill of Harvard Medical School stated, “Recent studies have shown that beta-hydroxybutyrate, the principle ‘ketone’ is not just a fuel, but a ‘superfuel’ more efficiently producing ATP energy than glucose. . . . It has also protected neuronal cells in tissue culture against exposure to toxins associated with Alzheimer’s or Parkinson’s.”

Indeed, well beyond serving as a brain superfuel, Dr. Cahill and other researchers have determined that beta-HBA has other profoundly positive effects on brain health and function. Essentially, beta-HBA is thought to mediate many of the positive effects of calorie reduction and fasting on the brain, including improved antioxidant function, increased mitochondrial energy production with an increased in mitochondrial energy production with an increase in mitochondrial population, increased cellular survival, and increased levels of BDNF leading to enhanced growth of new brain cells (neurogenesis).

Fasting

Earlier, we explored the need to reduce caloric intake in order to increase BDNF as a means to stimulate the growth of new brain cells as well as to enhance the function of existing neurons. The idea of substantially reducing daily calorie intake will not appeal to many people despite the fact that it is a powerful approach to brain enhancement as well as overall health.

Interestingly, however, many people find the idea of intermittent fasting to be more appealing. Fasting is defined here as a complete abstinence from food for a defined period of time at regular intervals—our fasting program permits the drinking of water. Research demonstrates that many of the same health-providing and brain-enhancing genetic pathways activated by calorie reduction are similarly engaged by fasting—even for relatively short periods of time. Fasting actually speaks to your DNA, directing your genes to produce an astounding array of brain-enhancement factors.

Not only does fasting turn on the genetic machinery for the production of BDNF, but it also powers up the Nrf2 pathway, leading to enhanced detoxification, reduced inflammation, and increased production of brain-protective antioxidants. Fasting causes the brain to shift away from using glucose as a fuel to a metabolism that consumes ketones. When the brain metabolizes ketones for fuel, even the process of apoptosis is reduced, while mitochondrial genes turn their attention to mitochondrial replication. In this way, fasting shifts the brain’s basic metabolism and specifically targets the DNA of mitochondria, thus enhancing energy production and paving the way for better brain function and clarity . . .

* * *

Ketone bodies mimic the life span extending properties of caloric restriction
by Richard L. Veech Patrick C. Bradshaw Kieran Clarke William Curtis Robert Pawlosky M. Todd King

Aging in man is accompanied by deterioration of a number of systems. Most notable are a gradual increase in blood sugar and blood lipids, increased narrowing of blood vessels, an increase in the incidence of malignancies, the deterioration and loss of elasticity in skin, loss of muscular strength and physiological exercise performance, deterioration of memory and cognitive performance, and in males decreases in erectile function. Many aging‐induced changes, such as the incidence of malignancies in mice 82, the increases in blood glucose and insulin caused by insulin resistance 39, 78, and the muscular weakness have been shown to be decreased by the metabolism of ketone bodies 18, 83, a normal metabolite produced from fatty acids by liver during periods of prolonged fasting or caloric restriction 12.

The unique ability of ketone bodies to supply energy to brain during periods of impairment of glucose metabolism make ketosis an effective treatment for a number of neurological conditions which are currently without effective therapies. Impairment of cognitive function has also been shown to be improved by the metabolism of ketone bodies 84. Additionally, Alzheimer’s disease, the major cause of which is aging 20 can be improved clinically by the induction of mild ketosis in a mouse model of the disease 85 and in humans 86. Ketosis also improves function in Parkinson’s disease 87 which is thought to be largely caused by mitochondrial free radical damage 19, 88. Ketone bodies are also useful in ameliorating the symptoms of amyotrophic lateral sclerosis 89. It is also recognized that ketosis could have important therapeutic applications in a wide variety of other diseases 90 including Glut 1 deficiency, type I diabetes 91, obesity 78, 92, and insulin resistance 20, 39, 93, and diseases of diverse etiology 90.

In addition to ameliorating a number of diseases associated with aging, the general deterioration of cellular systems independent of specific disease seems related to ROS toxicity and the inability to combat it. In contrast increases in life span occur across a number of species with a reduction in function of the IIS pathway and/or an activation of the FOXO transcription factors, inducing expression of the enzymes required for free radical detoxification (Figs. 1 and 2). In C. elegans, these results have been accomplished using RNA interference or mutant animals. Similar changes should be able to be achieved in higher animals, including humans, by the administration of d‐βHB itself or its esters.

In summary, decreased signaling through the insulin/IGF‐1 receptor pathway increases life span. Decreased insulin/IGF‐1 receptor activation leads to a decrease in PIP3, a decrease in the phosphorylation and activity of phosphoinositide‐dependent protein kinase (PDPK1), a decrease in the phosphorylation and activity of AKT, and a subsequent decrease in the phosphorylation of FOXO transcription factors, allowing them to continue to reside in the nucleus and to increase the transcription of the enzymes of the antioxidant pathway.

In mammals, many of these changes can be brought about by the metabolism of ketone bodies. The metabolism of ketones lowers the blood glucose and insulin thus decreasing the activity of the IIS and its attendant changes in the pathway described above. However, in addition ketone bodies act as a natural inhibitor of class I HDACs, inducing FOXO gene expression stimulating the synthesis of antioxidant and metabolic enzymes. An added important factor is that the metabolism of ketone bodies in mammals increases the reducing power of the NADP system providing the thermodynamic drive to destroy oxygen free radicals which are a major cause of the aging process.

* * *

Insights into human evolution from ancient and contemporary microbiome studies
by Stephanie L Schnorr, Krithivasan Sankaranarayanan, Cecil M Lewis, Jr, and Christina Warinner

Brain growth, development, and behavior

The human brain is our defining species trait, and its developmental underpinnings are key foci of evolutionary genetics research. Recent research on brain development and social interaction in both humans and animal models has revealed that microbes exert a major impact on cognitive function and behavioral patterns []. For example, a growing consensus recognizes that cognitive and behavioral pathogenesis are often co-expressed with functional bowel disorders []. This hints at a shared communication or effector pathway between the brain and gut, termed the gutbrain-axis (GBA). The enteric environment is considered a third arm of the autonomic nervous system [], and gut microbes produce more than 90% of the body’s serotonin (5-hydroxytryptamine or 5-HT) []. Factors critical to learning and plasticity such as serotonin, γ-aminobutryic acid (GABA), short chain fatty acids (SCFAs), and brain derived neurotrophic factor (BDNF), which train amygdalin and hippocampal reactivity, can be mediated through gut-brain chemical signals that cross-activate bacterial and host receptors []. Probiotic treatment is associated with positive neurological changes in the brain such as increased BDNF, altered expression of GABA receptors, increased circulating glutathione, and a reduction in inflammatory markers. This implicates the gut microbiome in early emotional training as well as in affecting long-term cognitive plasticity.

Critically, gut microbiota can modulate synthesis of metabolites affecting gene expression for myelin production in the prefrontal cortex (PFC), presumably influencing the oligodendrocyte transcriptome []. Prosocial and risk associated behavior in probiotic treated mice, a mild analog for novelty-seeking and risk-seeking behaviors in humans, suggests a potential corollary between entrenched behavioral phenotypes and catecholamines (serotonin and dopamine) produced by the gut microbiota []. Evolutionary acceleration of the human PFC metabolome divergence from chimpanzees, particularly the dopaminergic synapse [], reifies the notion that an exaggerated risk-reward complex characterizes human cognitive differentiation, which is facilitated by microbiome derived bioactive compounds. Therefore, quintessentially human behavioral phenotypes in stress, anxiety, and novelty-seeking is additionally reinforced by microbial production of neuroactive compounds. As neurological research expands to include the microbiome, it is increasingly clear that host–microbe interactions have likely played an important role in human brain evolution and development [].

Ancient human microbiomes
by Christina Warinner, Camilla Speller, Matthew J. Collins, and Cecil M. Lewis, Jr

Need for paleomicrobiology data

Although considerable effort has been invested in characterizing healthy gut and oral microbiomes, recent investigations of rural, non-Western populations () have raised questions about whether the microbiota we currently define as normal have been shaped by recent influences of modern Western diet, hygiene, antibiotic exposure, and lifestyle (). The process of industrialization has dramatically reduced our direct interaction with natural environments and fundamentally altered our relationship with food and food production. Situated at the entry point of our food, and the locus of food digestion, the human oral and gut microbiomes have evolved under conditions of regular exposure to a diverse range of environmental and zoonotic microbes that are no longer present in today’s globalized food chain. Additionally, the foods themselves have changed from the wild natural products consumed by our hunter-gatherer ancestors to today’s urban supermarkets stocked with an abundance of highly processed Western foodstuffs containing artificially enriched levels of sugar, oil, and salt, not to mention antimicrobial preservatives, petroleum-based colorants, and numerous other artificial ingredients. This dietary shift has altered selection pressure on our microbiomes. For example, under the ‘ecological plaque hypothesis’, diseases such as dental caries and periodontal disease are described as oral ecological catastrophes of cultural and lifestyle choices ().

Although it is now clear that the human microbiome plays a critical role in making us human, in keeping us healthy, and in making us sick, we know remarkably little about the diversity, variation, and evolution of the human microbiome both today and in the past. Instead, we are left with many questions: When and how did our bacterial communities become distinctly human? And what does this mean for our microbiomes today and in the future? How do we acquire and transmit microbiomes and to what degree is this affected by our cultural practices and built environments? How have modern Western diets, hygiene practices, and antibiotic exposure impacted ‘normal’ microbiome function? Are we still in mutualistic symbiosis with our microbiomes, or are the so-called ‘diseases of civilization’ – heart disease, obesity, type II diabetes, asthma, allergies, osteoporosis – evidence that our microbiomes are out of ecological balance and teetering on dysbiosis ()? At an even more fundamental level, who are the members of the human microbiome, how did they come to inhabit us, and how long have they been there? Who is ‘our microbial self’ ()?

Studies of remote and indigenous communities () and crowdsourcing projects such as the American Gut (www.americangut.org), the Earth Microbiome Project (www.earthmicrobiome.org), and uBiome (www.uBiome.com) are attempting to characterize modern microbiomes across a range of contemporary environments. Nevertheless, even the most extensive sampling of modern microbiota will provide limited insight into Pre-Industrial microbiomes. By contrast, the direct investigation of ancient microbiomes from discrete locations and time points in the past would provide a unique view into the coevolution of microbes and hosts, host microbial ecology, and changing human health states through time. […]

Diet also plays a role in shaping the composition of oral microbiomes, most notably by the action of dietary sugar in promoting the growth of cariogenic bacteria such as lactobacilli and S. mutans (). Two recent papers have proposed that cariogenic bacteria, such as S. mutans, were absent in pre-Neolithic human populations, possibly indicating low carbohydrate diets (), while evolutionary genomic analyses of S. mutans suggest an expansion in this species approximately 10,000 years, coinciding with the onset of agriculture (). […]

Ancient microbiome research provides an additional pathway to understanding human biology that cannot be achieved by studies of extant individuals and related species alone. Although reconstructing the ancestral microbiome by studying our ancestors directly is not without challenges (), this approach provides a more direct picture of human-microbe coevolution. Likewise, ancient microbiome sources may reveal to what extent bacteria commonly considered ‘pathogenic’ in the modern world (for example, H. pylori) were endemic indigenous organisms in pre-Industrial microbiomes ().

The three paths to reconstructing the ancestral microbiomes are also complimentary. For example, analysis of the gut microbiome from extant, rural peoples in Africa and South America have revealed the presence of a common, potentially commensal, spirochete belonging to the genus Treponema (). Such spirochetes have also been detected in extant hunter-gatherers (), and in 1,000-year-old human coprolites from Mexico (), but they are essentially absent from healthy urban populations, and they have not been reported in the gut microbiome of chimpanzees (). These multiple lines of evidence suggest that this poorly understood spirochete is a member of the ancestral human microbiome, yet not necessarily the broader primate microbiome. Future coprolite research may be able to answer the question of how long this microbe has co-associated with humans, and what niche it fills.

The Latest in Darwinian Medical Science: 12 Noteworthy New Papers That Shed Evolutionary Light on Health and Disease
by Eirik Garnas

Exposure of the Host-Associated Microbiome to Nutrient-Rich Conditions May Lead to Dysbiosis and Disease Development—an Evolutionary Perspective

The gist of what the paper is about:

We here propose that overfeeding of the host-associated bacterial community, particularly with easily digestible, energy-dense, low-fiber-content foods, likely causes dysbiosis and the development of disease. Overfeeding uncouples natural host-microbe associations, leading to an increased activity and changed functionality of the associated microbiota.

Continue reading…

My comments:
This paper sheds light on an important, yet often overlooked facet of the recent assault on the human microbiome, namely the effects of overfeeding. While it’s widely recognized that fast food doesn’t do the microbiome good, it’s somewhat underappreciated that changes pertaining to our meal pattern and total caloric intake have also undermined human-microbe relations.

Whereas our primal ancestors often did things, like chasing game, on an empty stomach, many humans of the 21st century could be said to almost constantly be in a fed, as opposed to fasted, state. This paper helps draw attention to the microbiome-related implications of this mismatch and suggests that many of the health benefits of intermittent fasting are mediated by gut bacteria.

* * *

Ketogenic Diet and Neurocognitive Health
Spartan Diet
The Agricultural Mind
Malnourished Americans

Can Ketogenic Diets Work for Bodybuilding or Athletics?
by P. D. Mangan

Here’s how I’d summarize the ‘keto for sports’ evidence so far:

  • The longer the study…or the longer its keto-adaptation phase…or the more keto-adapted the subjects are…the more likely the study is to find favorable performance results
  • Keto is worth trying for anyone in any sport (but start in the off-season!)
  • It’s highly unlikely keto is better for high-intensity
  • It’s unlikely that keto is bad for high-intensity
  • It’s likely that keto is neutral for high-intensity
  • It’s likely that keto diets are better for endurance
  • It’s very likely keto diets are better for body composition
  • It’s very likely keto diets are generally healthier than standard high-carb diets for athletes

Neuroscientist Shows What Fasting Does To Your Brain & Why Big Pharma Won’t Study It
by Arjun Walia

Does Fasting Make You Smarter?
by Derek Beres

Fasting Cleans the Brain
by P. D. Mangan

How Fasting Heals Your Brain
by Adriana Ayales

Effect of Intermittent Fasting on Brain Neurotransmitters, Neutrophils Phagocytic Activity, and Histopathological Finding in Some Organs in Rats
by Sherif M. Shawky, Anis M. Zaid, Sahar H. Orabi, Khaled M. Shoghy, and Wafaa A. Hassan

The Effects of Fasting During Ramadan on the Concentration of Serotonin, Dopamine, Brain-Derived Neurotrophic Factor and Nerve Growth Factor
by Abdolhossein Bastani, Sadegh Rajabi, and Fatemeh Kianimarkani

Gut microbiome, SCFAs, mood disorders, ketogenic diet and seizures
by Jonathan Miller

Study: Ketogenic diet appears to prevent cognitive decline in mice
by University of Kentucky

Low-carb Diet Alleviates Inherited Form of Intellectual Disability in Mice
by Johns Hopkins Medicine

Ketogenic Diet Protects Against Alzheimer’s Disease by Keeping Your Brain Healthy and Youthful
by Joseph Mercola

The Gut Microbiota Mediates the Anti-Seizure Effects of the Ketogenic Diet.
by C. A. Olson

Is the Keto Diet Bad for the Microbiome?
by David Jockers

Does a Ketogenic Diet Change Our Microbiome?
by Christie Rice

Can Health Issues Be Solved By Dietary Changes Altering the Microbiome?
by Russ Schierling

Some Benefits of Intermittent Fasting are Mediated by the Gut Microbiome
by Fight Aging!

RHR: Is High Fat Healthy for the Gut Microbiota?
by Chris Kresser

A Comprehensive List of Low Carb Research
by Sarah Hallberg

Randomised Controlled Trials Comparing Low-Carb Diets Of Less Than 130g Carbohydrate Per Day To Low-Fat Diets Of Less Than 35% Fat Of Total Calories
from Public Health Collaboration

The Agricultural Mind

Let me make an argument about (hyper-)individualism, rigid egoic boundaries, and hence Jaynesian consciousness (about Julian Jaynes, see other posts). But I’ll come at it from a less typical angle. I’ve been reading much about diet, nutrition, and health. With agriculture, the entire environment in which humans lived was fundamentally transformed, such as the rise of inequality and hierarchy, concentrated wealth and centralized power; not to mention the increase of parasites and diseases from urbanization and close cohabitation with farm animals (The World Around Us). We might be able to thank early agricultural societies, as an example, for introducing malaria to the world.

Maybe more importantly, there are significant links between what we eat and so much else: gut health, hormonal regulation, immune system, and neurocognitive functioning. There are multiple pathways, one of which is direct, connecting the gut and the brain: nervous system, immune system, hormonal system, etc — with the affect of diet and nutrition on immune response, including leaky gut, consider the lymphatic-brain link (Neuroscience News, Researchers Find Missing Link Between the Brain and Immune System) with the immune system as what some refer to as the “mobile mind” (Susan L. Prescott & Alan C. Logan, The Secret Life of Your Microbiome, pp. 64-7, pp. 249-50). As for a direct and near instantaneous gut-brain link, there was a recent discovery of the involvement of the vagus nerve, a possible explanation for the ‘gut sense’, with the key neurotransmitter glutamate modulating the rate of transmission in synaptic communication between enteroendocrine cells and vagal nerve neurons (Rich Haridy, Fast and hardwired: Gut-brain connection could lead to a “new sense”), and this is implicated in “episodic and spatial working memory” that might assist in the relocation of food sources (Rich Haridy, Researchers reveal how disrupting gut-brain communication may affect learning and memory). The gut is sometimes called the second brain because it also has neuronal cells, but in evolutionary terms it is the first brain. To demonstrate one example of a connection, many are beginning to refer to Alzheimer’s as type 3 diabetes, and dietary interventions have reversed symptoms in clinical studies. Also, gut microbes and parasites have been shown to influence our neurocognition and psychology, even altering personality traits and behavior such as with toxoplasma gondii. [For more discussion, see Fasting, Calorie Restriction, and Ketosis.]

The gut-brain link explains why glutamate as a food additive might be so problematic for so many people. Much of the research has looked at other health areas, such as metabolism or liver functioning. It would make more sense to look at its effect on neurocognition, but as with many other particles many scientists have dismissed the possibility of glutamate passing the blood-brain barrier. Yet we now know many things that were thought to be kept out of the brain do, under some conditions, get into the brain. After all, the same mechanisms that cause leaky gut (e.g., inflammation) can also cause permeability in the brain. So, we know the mechanism about how this could happen. Evidence is pointing in this direction: “MSG acts on the glutamate receptors and releases neurotransmitters which play a vital role in normal physiological as well as pathological processes (Abdallah et al., 2014[]). Glutamate receptors have three groups of metabotropic receptors (mGluR) and four classes of ionotropic receptors (NMDA, AMPA, delta and kainite receptors). All of these receptor types are present across the central nervous system. They are especially numerous in the hypothalamus, hippocampus and amygdala, where they control autonomic and metabolic activities (Zhu and Gouaux, 2017[]). Results from both animal and human studies have demonstrated that administration of even the lowest dose of MSG has toxic effects. The average intake of MSG per day is estimated to be 0.3-1.0 g (Solomon et al., 2015[]). These doses potentially disrupt neurons and might have adverse effects on behaviour” (Kamal Niaz, Extensive use of monosodium glutamate: A threat to public health?).

One possibility to consider is the role of exorphins that are addictive and can be blocked in the same way as opioids. Exorphin, in fact, means external morphine-like substance, in the way that endorphin means indwelling morphine-like substance. Exorphins are found in milk and wheat. Milk, in particular, stands out. Even though exorphins are found in other foods, it’s been argued that they are insignificant because they theoretically can’t pass through the gut barrier, much less the blood-brain barrier. Yet exorphins have been measured elsewhere in the human body. One explanation is gut permeability (related to permeability throughout the body) that can be caused by many factors such as stress but also by milk. The purpose of milk is to get nutrients into the calf and this is done by widening the space in gut surface to allow more nutrients through the protective barrier. Exorphins get in as well and create a pleasurable experience to motivate the calf to drink more. Along with exorphins, grains and dairy also contain dopaminergic peptides, and dopamine is the other major addictive substance. It feels good to consume dairy as with wheat, whether you’re a calf or a human, and so one wants more. Think about that the next time you pour milk over cereal.

Addiction, of food or drugs or anything else, is a powerful force. And it is complex in what it affects, not only physiologically and psychologically but also on a social level. Johann Hari offers a great analysis in Chasing the Scream. He makes the case that addiction is largely about isolation and that the addict is the ultimate individual (see To Put the Rat Back in the Rat Park, Rationalizing the Rat Race, Imagining the Rat Park, & Individualism and Isolation), and by the way this connects to Jaynesian consciousness with its rigid egoic boundaries as opposed to the bundled and porous mind, the extended and enmeshed self of bicameralism and animism. It stands out to me that addiction and addictive substances have increased over civilization, and I’ve argued that this is about a totalizing cultural system and a fully encompassing ideological worldview, what some call a reality tunnel (see discussion of addiction and social control in Diets and Systems & Western Individuality Before the Enlightenment Age). Growing of poppies, sugar, etc came later on in civilization, as did the production of beer and wine — by the way, alcohol releases endorphins, sugar causes a serotonin high, and both activate the hedonic pathway. Also, grain and dairy were slow to catch on, as a large part of the diet. Until recent centuries, most populations remained dependent on animal foods, including wild game (I discuss this era of dietary transition and societal transformation in numerous posts with industrialization and technology pushing the already stressed agricultural mind to an extreme: Ancient Atherosclerosis?To Be Fat And Have Bread, Autism and the Upper Crust“Yes, tea banished the fairies.”, Voice and Perspective, Hubris of Nutritionism, Health From Generation To GenerationDietary Health Across GenerationsMoral Panic and Physical DegenerationThe Crisis of IdentityThe Disease of Nostalgia, & Technological Fears and Media Panics). Americans, for example, ate large amounts of meat, butter, and lard from the colonial era through the 19th century (see Nina Teicholz, The Big Fat Surprise; passage quoted in full at Malnourished Americans). In 1900, Americans on average were only getting 10% of their calorie intake from carbohydrates and sugar was minimal, a potentially ketogenic diet considering how much lower calorie the average diet was back then.

Something else to consider is that low-carb diets can alter how the body and brain functions (the word ‘alter’ is inaccurate, though, since in evolutionary terms ketosis would’ve been the normal state; and so rather the modern high-carb diet is altered from the biological norm). That is even more true if combined with intermittent fasting and restricted eating times that would have been more common in the past (Past Views On One Meal A Day (OMAD)). Interestingly, this only applies to adults since we know that babies remain in ketosis during breastfeeding, there is evidence that they are already in ketosis in utero, and well into the teen years humans apparently remain in ketosis: “It is fascinating to see that every single child , so far through age 16, is in ketosis even after a breakfast containing fruits and milk” (Angela A. Stanton, Children in Ketosis: The Feared Fuel). “I have yet to see a blood ketone test of a child anywhere in this age group that is not showing ketosis both before and after a meal” (Angela A. Stanton, If Ketosis Is Only a Fad, Why Are Our Kids in Ketosis?). Ketosis is not only safe but necessary for humans (“Is keto safe for kids?”). Taken together, earlier humans would have spent more time in ketosis (fat-burning mode, as opposed to glucose-burning) which dramatically affects human biology. The further one goes back in history the greater amount of time people probably spent in ketosis. One difference with ketosis is that, for many people, cravings and food addictions disappear. [For more discussion of this topic, see previous posts: Fasting, Calorie Restriction, and Ketosis, Ketogenic Diet and Neurocognitive HealthIs Ketosis Normal?, & “Is keto safe for kids?”.] It’s a non-addictive or maybe even anti-addictive state of mind, similar to how certain psychedelics can be used to break addiction — one might argue there is a historical connection over the millennia between a decrease of psychedelic use and an increase of addictive substances (Diets and Systems, “Yes, tea banished the fairies.”, & Wealth, Power, and Addiction). Many hunter-gatherer tribes can go days without eating and it doesn’t appear to bother them, such as Daniel Everett’s account of the Piraha, and that is typical of ketosis — fasting forces one into ketosis, if one isn’t already in ketosis, and so beginning a fast in ketosis makes it even easier. This was also observed of Mongol warriors who could ride and fight for days on end without tiring or needing to stop for food. What is also different about hunter-gatherers and similar traditional societies is how communal they are or were and how more expansive their identities in belonging to a group, the opposite of the addictive egoic mind of high-carb agricultural societies. Anthropological research shows how hunter-gatherers often have a sense of personal space that extends into the environment around them. What if that isn’t merely cultural but something to do with how their bodies and brains operate? Maybe diet even plays a role. Hold that thought for a moment.

Now go back to the two staples of the modern diet, grains and dairy. Besides exorphins and dopaminergic substances, they also have high levels of glutamate, as part of gluten and casein respectively. Dr. Katherine Reid is a biochemist whose daughter was diagnosed with autism and it was severe. She went into research mode and experimented with supplementation and then diet. Many things seemed to help, but the greatest result came from restriction of dietary glutamate, a difficult challenge as it is a common food additive (see her TED talk here and another talk here or, for a short and informal video, look here). This requires going on a largely whole foods diet, that is to say eliminating processed foods (also see Traditional Foods diet of Weston A. Price and Sally Fallon Morell, along with the GAPS diet of Natasha Campbell-McBride). But when dealing with a serious issue, it is worth the effort. Dr. Reid’s daughter showed immense improvement to such a degree that she was kicked out of the special needs school. After being on this diet for a while, she socialized and communicated normally like any other child, something she was previously incapable of. Keep in mind that glutamate, as mentioned above, is necessary as a foundational neurotransmitter in modulating communication between the gut and brain. But typically we only get small amounts of it, as opposed to the large doses found in the modern diet. In response to the TED Talk given by Reid, Georgia Ede commented that it’s, “Unclear if glutamate is main culprit, b/c a) little glutamate crosses blood-brain barrier; b) anything that triggers inflammation/oxidation (i.e. refined carbs) spikes brain glutamate production.” Either way, glutamate plays a powerful role in brain functioning. And no matter the exact line of causation, industrially processed foods in the modern diet would be involved. By the way, an exacerbating factor might be mercury in its relation to anxiety and adrenal fatigue, as it ramps up the fight or flight system via over-sensitizing the glutamate pathway — could this be involved in conditions like autism where emotional sensitivity is a symptom? Mercury and glutamate simultaneously increasing in the modern world demonstrates how industrialization can push the effects of the agricultural diet to ever further extremes.

Glutamate is also implicated in schizophrenia: “The most intriguing evidence came when the researchers gave germ-free mice fecal transplants from the schizophrenic patients. They found that “the mice behaved in a way that is reminiscent of the behavior of people with schizophrenia,” said Julio Licinio, who co-led the new work with Wong, his research partner and spouse. Mice given fecal transplants from healthy controls behaved normally. “The brains of the animals given microbes from patients with schizophrenia also showed changes in glutamate, a neurotransmitter that is thought to be dysregulated in schizophrenia,” he added. The discovery shows how altering the gut can influence an animals behavior” (Roni Dengler, Researchers Find Further Evidence That Schizophrenia is Connected to Our Guts; reporting on Peng Zheng et al, The gut microbiome from patients with schizophrenia modulates the glutamate-glutamine-GABA cycle and schizophrenia-relevant behaviors in mice, Science Advances journal). And glutamate is involved in other conditions as well, such as in relation to GABA: “But how do microbes in the gut affect [epileptic] seizures that occur in the brain? Researchers found that the microbe-mediated effects of the Ketogenic Diet decreased levels of enzymes required to produce the excitatory neurotransmitter glutamate. In turn, this increased the relative abundance of the inhibitory neurotransmitter GABA. Taken together, these results show that the microbe-mediated effects of the Ketogenic Diet have a direct effect on neural activity, further strengthening support for the emerging concept of the ‘gut-brain’ axis.” (Jason Bush, Important Ketogenic Diet Benefit is Dependent on the Gut Microbiome). Glutamate is one neurotransmitter among many that can be affected in a similar manner; e.g., serotonin is also produced in the gut.

That reminds me of propionate, a short chain fatty acid and the conjugate base of propioninic acid. It is another substance normally taken in at a low level. Certain foods, including grains and dairy, contain it. The problem is that, as a useful preservative, it has been generously added to the food supply. Research on rodents shows injecting them with propionate causes autistic-like behaviors. And other rodent studies show how this stunts learning ability and causes repetitive behavior (both related to the autistic demand for the familiar), as too much propionate entrenches mental patterns through the mechanism that gut microbes use to communicate to the brain how to return to a needed food source, similar to the related function of glutamate. A recent study shows that propionate not only alters brain functioning but brain development (L.S. Abdelli et al, Propionic Acid Induces Gliosis and Neuro-inflammation through Modulation of PTEN/AKT Pathway in Autism Spectrum Disorder), and this is a growing field of research (e.g., Hyosun Choi, Propionic acid induces dendritic spine loss by MAPK/ERK signaling and dysregulation of autophagic flux). As reported by Suhtling Wong-Vienneau at University of Central Florida, “when fetal-derived neural stem cells are exposed to high levels of Propionic Acid (PPA), an additive commonly found in processed foods, it decreases neuron development” (Processed Foods May Hold Key to Rise in Autism). This study “is the first to discover the molecular link between elevated levels of PPA, proliferation of glial cells, disturbed neural circuitry and autism.” The impact is profound and permanent — Pedersen offers the details:

“In the lab, the scientists discovered that exposing neural stem cells to excessive PPA damages brain cells in several ways: First, the acid disrupts the natural balance between brain cells by reducing the number of neurons and over-producing glial cells. And although glial cells help develop and protect neuron function, too many glia cells disturb connectivity between neurons. They also cause inflammation, which has been noted in the brains of autistic children. In addition, excessive amounts of the acid shorten and damage pathways that neurons use to communicate with the rest of the body. This combination of reduced neurons and damaged pathways hinder the brain’s ability to communicate, resulting in behaviors that are often found in children with autism, including repetitive behavior, mobility issues and inability to interact with others.”

So, the autistic brain develops according to higher levels of propionate and maybe becomes accustomed to it. A state of dysfunction becomes what feels normal. Propionate causes inflammation and, as Dr. Ede points out, “anything that triggers inflammation/oxidation (i.e. refined carbs) spikes brain glutamate production”. High levels of propionate and glutamate become part of the state of mind the autistic becomes identified with. It all links together. Autistics, along with cravings for foods containing propionate (and glutamate), tend to have larger populations of a particular gut microbe that produces propionate. In killing microbes, this might be why antibiotics can help with autism. But in the case of depression, gut issues are associated instead with the lack of certain microbes that produce butyrate, another important substance that also is found in certain foods (Mireia Valles-Colomer et al, The neuroactive potential of the human gut microbiota in quality of life and depression). Depending on the specific gut dysbiosis, diverse neurocognitive conditions can result. And in affecting the microbiome, changes in autism can be achieved through a ketogenic diet, temporarily reducing the microbiome (similar to an antibiotic) — this presumably takes care of the problematic microbes and readjusts the gut from dysbiosis to a healthier balance. Also, ketosis would reduce the inflammation that is associated with glutamate production.

As with propionate, exorphins injected into rats will likewise elicit autistic-like behaviors. By two different pathways, the body produces exorphins and propionate from the consumption of grains and dairy, the former from the breakdown of proteins and the latter produced by gut bacteria in the breakdown of some grains and refined carbohydrates (combined with the propionate used as a food additive; and also, at least in rodents, artificial sweeteners increase propionate levels). [Plus, consider this hypothesis: “Thiamine deficiency is what made civilization. Grains deplete it, changing the gut flora to make more nervous and hyperfocused (mildly autistic) humans who are afraid to stand out. Conformity. Specialization in the division of labor” (JJ, Is Thiamine Deficiency Destroying Your Digestive Health? Why B1 Is ESSENTIAL For Gut Function, EONutrition).] This is part of the explanation for why many autistics have responded well to ketosis from carbohydrate restriction, specifically paleo diets that eliminate both wheat and dairy, but ketones themselves play a role in using the same transporters as propionate and so block their buildup in cells and, of course, ketones offer a different energy source for cells as a replacement for glucose which alters how cells function, specifically neurocognitive functioning and its attendant psychological effects.

There are some other factors to consider as well. With agriculture came a diet high in starchy carbohydrates and sugar. This inevitably leads to increased metabolic syndrome, including diabetes. And diabetes in pregnant women is associated with autism and attention deficit disorder in children. “Maternal diabetes, if not well treated, which means hyperglycemia in utero, that increases uterine inflammation, oxidative stress and hypoxia and may alter gene expression,” explained Anny H. Xiang. “This can disrupt fetal brain development, increasing the risk for neural behavior disorders, such as autism” (Maternal HbA1c influences autism risk in offspring); by the way, other factors such as getting more seed oils and less B vitamins are also contributing factors to metabolic syndrome and altered gene expression, including being inherited epigenetically, not to mention mutagenic changes to the genes themselves (Catherine Shanahan, Deep Nutrition). The increase of diabetes, not mere increase of diagnosis, could partly explain the greater prevalence of autism over time. Grain surpluses only became available in the 1800s, around the time when refined flour and sugar began to become common. It wasn’t until the following century that carbohydrates finally overtook animal foods as the mainstay of the diet, specifically in terms of what is most regularly eaten throughout the day in both meals and snacks — a constant influx of glucose into the system.

A further contributing factor in modern agriculture is that of pesticides, also associated with autism. Consider DDE, a product of DDT, which has been banned for decades but apparently it is still lingering in the environment. “The odds of autism among children were increased, by 32 percent, in mothers whose DDE levels were high (high was, comparatively, 75th percentile or greater),” one study found (Aditi Vyas & Richa Kalra, Long lingering pesticides may increase risk for autism: Study). “Researchers also found,” the article reports, “that the odds of having children on the autism spectrum who also had an intellectual disability were increased more than two-fold when the mother’s DDE levels were high.” A different study showed a broader effect in terms of 11 pesticides still in use:

“They found a 10 percent or more increase in rates of autism spectrum disorder, or ASD, in children whose mothers lived during pregnancy within about a mile and a quarter of a highly sprayed area. The rates varied depending on the specific pesticide sprayed, and glyphosate was associated with a 16 percent increase. Rates of autism spectrum disorders combined with intellectual disability increased by even more, about 30 percent. Exposure after birth, in the first year of life, showed the most dramatic impact, with rates of ASD with intellectual disability increasing by 50 percent on average for children who lived within the mile-and-a-quarter range. Those who lived near glyphosate spraying showed the most increased risk, at 60 percent” (Nicole Ferox, It’s Personal: Pesticide Exposures Come at a Cost).

An additional component to consider are plant anti-nutrients. For example, oxalates may be involved in autism spectrum disorder (Jerzy Konstantynowicz et al, A potential pathogenic role of oxalate in autism). With the end of the Ice Age, vegetation became more common and some of the animal foods less common. That increased plant foods as part of the human diet. But even then it was limited and seasonal. The dying off of the megafauna was a greater blow, as it forced humans to both rely on less desirable lean meats from smaller prey but also more plant foods. And of course, the agricultural revolution followed shortly after that with its devastating effects. None of these changes were kind to human health and development, as the evidence shows in the human bones and mummies left behind. Yet they were minor compared to what was to come. The increase of plant foods was a slow process over millennia. All the way up to the 19th century, Americans were eating severely restricted amounts of plant foods and instead depending on fatty animal foods, from pasture-raised butter and lard to wild-caught fish and deer — the abundance of wilderness and pasturage made such foods widely available, convenient, and cheap, besides being delicious and nutritious. Grain crops and vegetable gardens were simply too hard to grow, as described by Nina Teicholz in The Big Fat Surprise (see quoted passage at Malnourished Americans).

While maintaining a garden at Walden Pond by growing beans, peas, corn, turnips and potatoes, a plant-based diet (Jennie Richards, Henry David Thoreau Advocated “Leaving Off Eating Animals”) surely contributed to Henry David Thoreau’s declining health from tuberculosis in weakening his immune system from deficiency in the fat-soluble vitamins, although his nearby mother occasionally made him a fruit pie that would’ve had nutritious lard in the crust: “lack of quality protein and excess of carbohydrate foods in Thoreau’s diet as probable causes behind his infection” (Dr. Benjamin P. Sandler, Thoreau, Pulmonary Tuberculosis and Dietary Deficiency). Likewise, Franz Kafka who became a vegetarian also died from tuberculosis (Old Debates Forgotten). Weston A. Price observed the link between deficiency of fat-soluble vitamins and high rates of tuberculosis, not that one causes the other but that nutritious diet is key to a strong immune system (Dr. Kendrick On Vaccines & Moral Panic and Physical Degeneration). Besides, eliminating fatty animal foods typically means increasing starchy and sugary plant foods, which lessens the anti-inflammatory response from ketosis and autophagy and hence the capacity for healing.

It should be re-emphasized the connection of physical health to mental health, another insight of Price. Interestingly, Kafka suffered from psychological, presumably neurocognitive, issues long before tubercular symptoms showed up and he came to see the link between them as causal, although he saw it the the other way around as psychosomatic. Even more intriguing, Kafka suggests that, as Sander L. Gilman put it, “all urban dwellers are tubercular,” as if it is a nervous condition of modern civilization akin to what used to be called neurasthenia (about Kafka’s case, see Sander L. Gilman’s Franz Kafka, the Jewish Patient). He even uses the popular economic model of energy and health: “For secretly I don’t believe this illness to be tuberculosis, at least primarily tuberculosis, but rather a sign of general bankruptcy” (for context, see The Crisis of Identity). Speaking of the eugenic, hygienic, sociological and aesthetic, Gillman further notes that, “For Kafka, that possibility is linked to the notion that illness and creativity are linked, that tuberculars are also creative geniuses,” indicating an interpretation of neurasthenia among the intellectual class, an interpretation that was more common in the United States than in Europe.

The upper classes were deemed the most civilized and so it was expected they they’d suffer the most from the diseases of civilization, and indeed the upper classes fully adopted the modern industrial diet before the rest of the population. In contrast, while staying at a sanatorium (a combination of the rest cure and the west cure), Kafka stated that, “I am firmly convinced, now that I have been living here among consumptives, that healthy people run no danger of infection. Here, however, the healthy are only the woodcutters in the forest and the girls in the kitchen (who will simply pick uneaten food from the plates of patients and eat it—patients whom I shrink from sitting opposite) but not a single person from our town circles,” from a letter to Max Brod on March 11, 1921. It should be pointed out that tuberculosis sanatoriums were typically located in rural mountain areas where local populations were known to be healthy, the kinds of communities Weston A. Price studied in the 1930s; a similar reason for why in America tuberculosis patients were sometimes sent west (the west cure) for clean air and a healthy lifestyle, probably with an accompanying change toward a rural diet, with more wild-caught animal foods higher in omega-3s and lower in omega-6s, not to mention higher in fat-soluble vitamins.

The historical context of public health overlapped with racial hygiene, and indeed some of Kafka’s family members and lovers would later die at the hands of Nazis. Eugenicists were obsessed with body types in relation to supposed racial features, but non-eugenicists also accepted that physical structure was useful information to be considered; and this insight is supported, if not the eugenicist ideology, by the more recent scientific measurements of stunted bone development in the early agricultural societies. Hermann Brehmer, a founder of the sanitorium movement, asserted that a particular body type (habitus phthisicus, equivalent to habitus asthenicus) was associated with tuberculosis, the kind of thinking that Weston A. Price would pick up in his observations in physical development, although Price saw the explanation as dietary and not racial. The other difference is that Price saw “body type” not as a cause but as a symptom of ill health, and so the focus on re-forming the body (through lung exercises, orthopedic corsets, etc) to improve health was not the most helpful advice. On the other hand, if re-forming the body involved something like the west cure in changing the entire lifestyle and environmental conditions, it might work by way of changing other factors of health and, along with diet, exercise and sunshine and clean air and water would definitely improve immune function, lower inflammation, and much else (sanitoriums prioritized such things as getting plenty of sunshine and dairy, both of which would increase vitamin D3 that is necessary for immunological health). Improvements in physical health, of course, would go hand in hand with that of mental health.

As a side note, physical development was tied up with gender issues and gender roles, especially for boys in becoming men. There became a fear that the newer generations of urban youth were failing to develop properly, physically and mentally, morally and socially. Fitness became a central concern for the civilizational project and it was feared that we modern humans might fail this challenge. Most galling of all was ‘feminization’, not only about loss of an athletic build but loss of something to the masculine psychology, involving the depression and anxiety, sensitivity and weakness of conditions like neurasthenia while also overlapping with tubercular consumption. Some of this could be projected onto racial inferiority, far from being limited to the distinction between those of European descent and all others for it also was used to divide humanity up in numerous ways (German vs French, English vs Irish, North vs South, rich vs poor, Protestants vs Catholics, Christians vs Jews, etc).

Gender norms were applied to all aspects of health and development, including perceived moral character and personality disposition. This is a danger to the individual, but also potentially a danger to society. “Here we can return for the moment to the notion that the male Jew is feminized like the male tubercular. The tubercular’s progressive feminization begins in the middle of the nineteenth century with the introduction of the term: infemminire, to feminize, which is supposedly a result of male castration. By the 1870s, the term is used to describe the feminisme of the male through the effects of other disease, such as tuberculosis. Henry Meige, at the Salpetriere, saw this feminization as an atavism, in which the male returns to the level of the “sexless” child. Feminization is therefore a loss, which can cause masturbation and thus illness in certain predisposed individuals. It is also the result of actual castration or its physiological equivalent, such as an intensely debilitating illness like tuberculosis, which reshapes the body” (Sanders L. Gilman, Franz Kafka, the Jewish Patient). There was a fear that all of civilization was becoming effeminate, especially among the upper classes who were expected to be the leaders. That was the entire framework of neurasthenia-obsessed rhetoric in late nineteenth to early twentieth century America. The newer generations of boys, the argument went, were somehow deficient and inadequate. Looking back on that period, there is no doubt that physical and mental illness was increasing, while bone structure was becoming underdeveloped in a way one could perceive as effeminate; such bone development problems are particularly obvious among children raised on plant-based diets, especially veganism and near-vegan vegetarianism, but also anyone on a diet lacking nutritious animal foods.

Let me make one odd connection before moving on. The Seventh Day Adventist Dr. John Harvey Kellogg believed masturbation was both a moral sin and a cause of ill health but also a sign of inferiority, and his advocacy of a high-fiber vegan diet including breakfast cereals was based on the Galenic theory that such foods decreased libido. Dr. Kellogg was also an influential eugenicist and operated a famous sanitorium. He wasn’t alone in blaming masturbation for disease. The British Dr. D. G. Macleod Munro treated masturbation as a contributing factor for tuberculosis: “the advent of the sexual appetite in normal adolescence has a profound effect upon the organism, and in many cases when uncontrolled, leads to excess about the age when tuberculosis most frequently delivers its first open assault upon the body,” as quoted by Gilman. This related to the ‘bankruptcy’ Kafka mentioned, the idea that one could waste one’s energy reserves. Maybe there is an insight in this belief, despite it being misguided and misinterpreted. The source of the ‘bankruptcy’ may have in part been a nutritional debt and certainly a high-fiber vegan diet would not refill ones energy and nutrient reserves as an investment in one’s health — hence, the public health risk of what one might call a hyper-agricultural diet as exemplified by the USDA dietary recommendations and corporate-backed dietary campaigns like EAT-Lancet (Dietary Dictocrats of EAT-Lancet; & Corporate Veganism), but it’s maybe reversing course, finally (Slow, Quiet, and Reluctant Changes to Official Dietary Guidelines; American Diabetes Association Changes Its Tune; & Corporate Media Slowly Catching Up With Nutritional Studies).

So far, my focus has mostly been on what we ingest or are otherwise exposed to because of agriculture and the food system, in general and more specifically in industrialized society with its refined, processed, and adulterated foods, largely from plants. But the other side of the picture is what our diet is lacking, what we are deficient in. As I touched upon directly above, an agricultural diet hasn’t only increased certain foods and substances but simultaneously decreased others. What promoted optimal health throughout human evolution has, in many cases, been displaced or interrupted. Agriculture is highly destructive and has depleted the nutrient-level in the soil (Carnivore Is Vegan) and, along with this, even animal foods as part of the agricultural system are similarly depleted of nutrients as compared to animal foods from pasture or free-range. For example, fat-soluble vitamins (true vitamin A as retinol, vitamin D3, vitamin K2 not to be confused with K1, and vitamin E complex) are not found in plant foods and are found in far less concentration with foods from animals from factory-farming or from grazing on poor soil from agriculture, especially the threat of erosion and desertification. Rhonda Patrick points to deficiencies of vitamin D3, EPA and DHA and hence insufficient serotonin levels as being causally linked to autism, ADHD, bipolar disorder, schizophrenia, etc (TheIHMC, Rhonda Patrick on Diet-Gene Interactions, Epigenetics, the Vitamin D-Serotonin Link and DNA Damage). She also discusses inflammation, epigenetics, and DNA damage which relates to the work by others (Dr. Catherine Shanahan On Dietary Epigenetics and Mutations).

One of the biggest changes with agriculture was the decrease of fatty animal foods that were nutrient-dense and nutrient-bioavailable. It’s in the fat that are found the fat-soluble vitamins and fat is necessary for their absorption (i.e., fat-soluble), and these key nutrients relate to almost everything else such as minerals as calcium and magnesium that also are found in animal foods (Calcium: Nutrient Combination and Ratios); the relationship of seafood with the balance of sodium, magnesium, and potassium is central (On Salt: Sodium, Trace Minerals, and Electrolytes) and indeed populations that eat more seafood live longer. These animal foods used to hold the prized position in the human diet and the earlier hominid diet as well, as part of our evolutionary inheritance from millions of years of adaptation to a world where fatty animals once were abundant (J. Tyler Faith, John Rowan & Andrew Du, Early hominins evolved within non-analog ecosystems). That was definitely true in the paleolithic before the megafauna die-off, but even to this day hunter-gatherers when they have access to traditional territory and prey will seek out the fattest animals available, entirely ignoring lean animals because rabbit sickness is worse than hunger (humans can always fast for many days or weeks, if necessary, and as long as they have reserves of body fat they can remain perfectly healthy).

We’ve already discussed autism in terms of many other dietary factors, especially excesses of otherwise essential nutrients like glutamate, propionate, and butyrate. But like most modern people, those on the autistic spectrum can be nutritionally deficient in other ways and unsurprisingly that would involve fat-soluble vitamins. In a fascinating discussion one of her more recent books, Nourishing Fats, Sally Fallon Morell offers a hypothesis of an indirect causal mechanism. First off, she notes that, “Dr. Mary Megson  of Richmond, Virginia, had noticed that night blindness and thyroid conditions—both signs of vitamin A deficiency—were common in family members of autistic children” (p. 156), and so indicating a probable deficiency of the same in the affected child. This might be why supplementing cod liver oil, high in true vitamin A, helps with autistic issues. “As Dr. Megson explains, in genetically predisposed children, autism is linked to a G-alpha protein defect. G-alpha proteins form one of the most prevalent signaling systems in our cells, regulating processes as diverse as cell growth, hormonal regulation and sensory perception—like seeing” (p. 157). The sensory issues common among autistics may seem to be neurocognitive in origin, but the perceptual and psychological effects may be secondary to the real cause in altered eye development. Because the rods in their eyes don’t function properly, they have distorted vision that is experienced as a blurry and divided visual field, like a magic-eye puzzle, that takes constant effort in making coherent sense of the world around them. “According to Megson, the blocked visual pathways explain why children on the autism spectrum “melt down” when objects are moved or when you clean up their lines or piles of toys sorted by color They work hard to piece together their world; it frightens and overwhelms them when the world as they are able to see it changes. It also might explain why children on the autism spectrum spend time organizing tings so carefully. It’s the only way they can “see” what’s out there” (p. 157). The rods at the edge of their vision work better and so they prefer to not look directly at people. The affect of the agricultural diet, especially in its industrially-processed variety, has a powerful impact on numerous systems simultaneously, as autism demonstrates. There is unlikely any single causal factor and causal mechanism with most other health conditions as well.

Let’s take this a step further. With historical changes in diet, it wasn’t only fat-soluble vitamins that were lost. Humans traditionally ate nose-to-tail and this brought with it a plethora of nutrients, even some thought of as being only sourced from plant foods. In its raw or lightly cooked form, meat has more than enough vitamin C for a low-carb diet; whereas a high-carb diet, since glucose competes with vitamin C, requires higher intake of this antioxidant which can lead to deficiencies at levels that otherwise would be adequate (Sailors’ Rations, a High-Carb Diet). Also, consider that prebiotics can be found in animal foods as well and animal-based prebiotics likely feeds a very different kind of microbiome that could shift so much else in the body, such as neurotransmitter production: “I found this list of prebiotic foods that were non-carbohydrate that included cellulose, cartilage, collagen, fructooligosaccharides, glucosamine, rabbit bone, hair, skin, glucose. There’s a bunch of things that are all — there’s also casein. But these tend to be some of the foods that actually have some of the highest prebiotic content,” from Vanessa Spina as quoted in Fiber or Not: Short-Chain Fatty Acids and the Microbiome). Let me briefly mention fat-soluble vitamins again in making a point about other animal-based nutrients. Fat-soluble vitamins, similar to ketosis and autophagy, have a profound effect on human biological functioning, including that of the mind (see the work of Weston A. Price as discussed in Health From Generation To Generation; also see the work of those described in Physical Health, Mental Health). In many ways, they are closer to hormones than mere nutrients, as they orchestrate entire systems in the body and how other nutrients get used, particularly seen with vitamin K2 that Weston A. Price discovered in calling it “Activator X” (only found in animal and fermented foods, not in whole or industrially-processed plant foods). I bring this up because some other animal-based nutrients play a similar important role. Consider glycine that is the main amino acid in collagen. It is available in connective tissues and can be obtained through soups and broths made from bones, skin, ligaments, cartilage, and tendons. Glycine is right up there with the fat-soluble vitamins in being central to numerous systems, processes, and organs.

As I’ve already discussed glutamate at great length, let me further that discussion by pointing out a key link. “Glycine is found in the spinal cord and brainstem where it acts as an inhibitory neurotransmitter via its own system of receptors,” writes Afifah Hamilton. “Glycine receptors are ubiquitous throughout the nervous system and play important roles during brain development. [Ito, 2016] Glycine also interacts with the glutaminergic neurotransmission system via NMDA receptors, where both glycine and glutamate are required, again, chiefly exerting inhibitory effects” (10 Reasons To Supplement With Glycine). Hamilton elucidates the dozens of roles played by this master nutrient and the diverse conditions that follow from its deprivation or insufficiency — it’s implicated in obsessive compulsive disorder, schizophrenia, and alcohol use disorder, along with much else such as metabolic syndrome. But it’s being essential to glutamate really stands out for this discussion. “Glutathione is synthesised,” Hamilton further explains, “from the amino acids glutamate, cysteine, and glycine, but studies have shown that the rate of synthesis is primarily determined by levels of glycine in the tissue. If there is insufficient glycine available the glutathione precursor molecules are excreted in the urine. Vegetarians excrete 80% more of these precursors than their omnivore counterparts indicating a more limited ability to complete the synthesis process.” Did you catch what she is saying there? Autistics already have too much glutamate and, if they are deficient in glycine, they won’t be able to convert glutamate into the important glutathione. When the body is overwhelmed with unused glutamate, it does what it can to eliminate them, but when constantly flooded with high-glutamate intake it can’t keep up. The excess glutamate then wreaks havoc on neurocognitive functioning.

The whole mess of the agricultural diet, specifically in its modern industrialized form, has been a constant onslaught taxing our bodies and minds. And the consequences are worsening with each generation. What stands out to me about autism, in particular, is how isolating it is. The repetitive behavior and focus on objects to the exclusion of human relationships resonates with how addiction isolates the individual. As with other conditions influenced by diet (shizophrenia, ADHD, etc), both autism and addiction block normal human relating in creating an obsessive mindset that, in the most most extreme forms, blocks out all else. I wonder if all of us moderns are simply expressing milder varieties of this biological and neurological phenomenon (Afifah Hamilton, Why No One Should Eat Grains. Part 3: Ten More Reasons to Avoid Wheat). And this might be the underpinning of our hyper-individualistic society, with the earliest precursors showing up in the Axial Age following what Julian Jaynes hypothesized as the breakdown of the much more other-oriented bicameral mind. What if our egoic consciousness with its rigid psychological boundaries is the result of our food system, as part of the civilizational project of mass agriculture?

* * *

Mongolian Diet and Fasting:

“Heaven grew weary of the excessive pride and luxury of China… I am from the Barbaric North. I wear the same clothing and eat the same food as the cowherds and horse-herders. We make the same sacrifices and we share our riches. I look upon the nation as a new-born child and I care for my soldiers as though they were my brothers.”
~Genghis Khan, letter of invitation to Ch’ang Ch’un

For anyone who is curious to learn more, the original point of interest for me was a quote by Jack Weatherford in his book Genghis Khan and the Making of the Modern World: “The Chinese noted with surprise and disgust the ability of the Mongol warriors to survive on little food and water for long periods; according to one, the entire army could camp without a single puff of smoke since they needed no fires to cook. Compared to the Jurched soldiers, the Mongols were much healthier and stronger. The Mongols consumed a steady diet of meat, milk, yogurt, and other diary products, and they fought men who lived on gruel made from various grains. The grain diet of the peasant warriors stunted their bones, rotted their teeth, and left them weak and prone to disease. In contrast, the poorest Mongol soldier ate mostly protein, thereby giving him strong teeth and bones. Unlike the Jurched soldiers, who were dependent on a heavy carbohydrate diet, the Mongols could more easily go a day or two without food.” By the way, that biography was written by an anthropologist who lived among and studied the Mongols for years. It is about the historical Mongols, but filtered through the direct experience of still existing Mongol people who have maintained a traditional diet and lifestyle longer than most other populations. It isn’t only that their diet was ketogenic because of being low-carb but also because it involved fasting.

From Mongolia Volume 1 The Tangut Country, and the Solitudes of Northernin (1876), Nikolaĭ Mikhaĭlovich Przhevalʹskiĭ writes in the second note on p. 65 under the section Calendar and Year-Cycle: “On the New Year’s Day, or White Feast of the Mongols, see ‘Marco Polo’, 2nd ed. i. p. 376-378, and ii. p. 543. The monthly fetival days, properly for the Lamas days of fasting and worship, seem to differ locally. See note in same work, i. p. 224, and on the Year-cycle, i. p. 435.” This is alluded to in another text, in describing that such things as fasting were the norm of that time: “It is well known that both medieval European and traditional Mongolian cultures emphasized the importance of eating and drinking. In premodern societies these activities played a much more significant role in social intercourse as well as in religious rituals (e.g., in sacrificing and fasting) than nowadays” (Antti Ruotsala, Europeans and Mongols in the middle of the thirteenth century, 2001). A science journalist trained in biology, Dyna Rochmyaningsih, also mentions this: “As a spiritual practice, fasting has been employed by many religious groups since ancient times. Historically, ancient Egyptians, Greeks, Babylonians, and Mongolians believed that fasting was a healthy ritual that could detoxify the body and purify the mind” (Fasting and the Human Mind).

Mongol shamans and priests fasted, no different than in so many other religions, but so did other Mongols — more from Przhevalʹskiĭ’s 1876 account showing the standard feast and fast cycle of many traditional ketogenic diets: “The gluttony of this people exceeds all description. A Mongol will eat more than ten pounds of meat at one sitting, but some have been known to devour an average-sized sheep in twenty-four hours! On a journey, when provisions are economized, a leg of mutton is the ordinary daily ration for one man, and although he can live for days without food, yet, when once he gets it, he will eat enough for seven” (see more quoted material in Diet of Mongolia). Fasting was also noted of earlier Mongols, such as Genghis Khan: “In the spring of 2011, Jenghis Khan summoned his fighting forces […] For three days he fasted, neither eating nor drinking, but holding converse with the gods. On the fourth day the Khakan emerged from his tent and announced to the exultant multitude that Heaven had bestowed on him the boon of victory” (Michael Prawdin, The Mongol Empire, 1967). Even before he became Khan, this was his practice as was common among the Mongols, such that it became a communal ritual for the warriors:

“When he was still known as Temujin, without tribe and seeking to retake his kidnapped wife, Genghis Khan went to Burkhan Khaldun to pray. He stripped off his weapons, belt, and hat – the symbols of a man’s power and stature – and bowed to the sun, sky, and mountain, first offering thanks for their constancy and for the people and circumstances that sustained his life. Then, he prayed and fasted, contemplating his situation and formulating a strategy. It was only after days in prayer that he descended from the mountain with a clear purpose and plan that would result in his first victory in battle. When he was elected Khan of Khans, he again retreated into the mountains to seek blessing and guidance. Before every campaign against neighboring tribes and kingdoms, he would spend days in Burhkhan Khandun, fasting and praying. By then, the people of his tribe had joined in on his ritual at the foot of the mountain, waiting his return” (Dr. Hyun Jin Preston Moon, Genghis Khan and His Personal Standard of Leadership).

As an interesting side note, the Mongol population have been studied to some extent in one area of relevance. In Down’s Anomaly (1976), Smith et al writes that, “The initial decrease in the fasting blood sugar was greater than that usually considered normal and the return to fasting blood sugar level was slow. The results suggested increased sensitivity to insulin. Benda reported the initial drop in fating blood sugar to be normal but the absolute blood sugar level after 2 hours was lower for mongols than for controls.” That is probably the result of a traditional low-carb diet that had been maintained continuously since before history. For some further context, I noticed some discusion about the Mongolian keto diet (Reddit, r/keto, TIL that Ghenghis Khan and his Mongol Army ate a mostly keto based diet, consisting of lots of milk and cheese. The Mongols were specially adapted genetically to digest the lactase in milk and this made them easier to feed.) that was inspired by the scientific documentary “The Evolution of Us” (presently available on Netflix and elsewhere).

* * *

3/30/19 – An additional comment: I briefly mentioned sugar, that it causes a serotonin high and activates the hedonic pathway. I also noted that it was late in civilization when sources of sugar were cultivated and, I could add, even later when sugar became cheap enough to be common. Even into the 1800s, sugar was minimal and still often considered more as medicine than food.

To extend this thought, it isn’t only sugar in general but specific forms of it. Fructose, in particular, has become widespread because of United States government subsidizing corn agriculture which has created a greater corn yield that humans can consume. So, what doesn’t get fed to animals or turned into ethanol, mostly is made into high fructose corn syrup and then added into almost every processed food and beverage imaginable.

Fructose is not like other sugars. This was important for early hominid survival and so shaped human evolution. It might have played a role in fasting and feasting. In 100 Million Years of Food, Stephen Le writes that, “Many hypotheses regarding the function of uric acid have been proposed. One suggestion is that uric acid helped our primate ancestors store fat, particularly after eating fruit. It’s true that consumption of fructose induces production of uric acid, and uric acid accentuates the fat-accumulating effects of fructose. Our ancestors, when they stumbled on fruiting trees, could gorge until their fat stores were pleasantly plump and then survive for a few weeks until the next bounty of fruit was available” (p. 42).

That makes sense to me, but he goes on to argue against this possible explanation. “The problem with this theory is that it does not explain why only primates have this peculiar trait of triggering fat storage via uric acid. After all, bears, squirrels, and other mammals store fat without using uric acid as a trigger.” This is where Le’s knowledge is lacking for he never discusses ketosis that has been centrally important for humans unlike other animals. If uric acid increases fat production, that would be helpful for fattening up for the next starvation period when the body returned to ketosis. So, it would be a regular switching back and forth between formation of uric acid that stores fat and formation of ketones that burns fat.

That is fine and dandy under natural conditions. Excess fructose on a continuous basiss, however, is a whole other matter. It has been strongly associated with metabolic syndrome. One pathway of causation is that increased production of uric acid. This can lead to gout but other things as well. It’s a mixed bag. “While it’s true that higher levels of uric acid have been found to protect against brain damage from Alzheimer’s, Parkinson’s, and multiple sclerosis, high uric acid unfortunately increases the risk of brain stroke and poor brain function” (Le, p. 43).

The potential side effects of uric acid overdose are related to other problems I’ve discussed in relation to the agricultural mind. “A recent study also observed that high uric acid levels are associated with greater excitement-seeking and impulsivity, which the researchers noted may be linked to attention deficit hyperactivity disorder (ADHD)” (Le, p. 43). The problems of sugar go far beyond mere physical disease. It’s one more factor in the drastic transformation of the human mind.

* * *

4/2/19 – More info: There are certain animal fats, the omega-3 fatty acids EPA and DHA, that are essential to human health (Georgia Ede, The Brain Needs Animal Fat). These were abundant in the hunter-gatherer diet. But over the history of agriculture, they have become less common.

This is associated with psychiatric disorders and general neurocognitive problems, including those already mentioned above in the post. Agriculture and industrialization have replaced these healthy lipids with industrially-processed seed oils that are high in linoleic acid (LA), an omega-6 fatty acids. LA interferes with the body’s use of omega-3 fatty acids. Worse still, these seed oils appear to not only alter gene expression (epigenetics) but also to be mutagenic, a possible causal factor behind conditions like autism (Dr. Catherine Shanahan On Dietary Epigenetics and Mutations).

The loss of healthy animal fats in the diet might be directly related to numerous conditions. “Children who lack DHA are more likely to have increased rates of neurological disorders, in particular attention deficit hyperactivity disorder (ADHD), and autism” (Maria Cross, Why babies need animal fat). Also, trans fats found in industrial seed oils are linked to Alzheimer’s as well (Millie Barnes, Alzheimer’s Risk May be 75% Higher for People Who Eat Trans Fats; Takanori Honda et al, Serum elaidic acid concentration and risk of dementia: The Hisayama study).

“Biggest dietary change in the last 60 years has been avoidance of animal fat. Coincides with a huge uptick in autism incidence. The human brain is 60 percent fat by weight. Much more investigation needed on correspondence between autism and prenatal/child ingestion of dietary fat.”
~ Brad Lemley

The agricultural diet, along with a drop in animal foods, saw a loss of access to the high levels and full profile of B vitamins. As with the later industrial seed oils, this had a major impact on genetics:

“The phenomenon wherein specific traits are toggled up and down by variations in gene expression has recently been recognized as a result of the built-in architecture of DNA and dubbed “active adaptive evolution.” 44

“As further evidence of an underlying logic driving the development of these new autism-related mutations, it appears that epigenetic factors activate the hotspot, particularly a kind of epigenetic tagging called methylation. 45 In the absence of adequate B vitamins, specific areas of the gene lose these methylation tags, exposing sections of DNA to the factors that generate new mutations. In other words, factors missing from a parent’s diet trigger the genome to respond in ways that will hopefully enable the offspring to cope with the new nutritional environment. It doesn’t always work out, of course, but that seems to be the intent.”
~Catherine Shanahan, Deep Nutrition, p. 56

And one last piece of evidence on the essential nature of animal fats:

“Maternal intake of fish, a key source of fatty acids, has been investigated in association with child neurodevelopmental outcomes in several studies. […]

“Though speculative at this time, the inverse association seen for those in the highest quartiles of intake of ω-6 fatty acids could be due to biological effects of these fatty acids on brain development. PUFAs have been shown to be important in retinal and brain development in utero (37) and to play roles in signal transduction and gene expression and as components of cell membranes (38, 39). Maternal stores of fatty acids in adipose tissue are utilized by the fetus toward the end of pregnancy and are necessary for the first 2 months of life in a crucial period of development (37). The complex effects of fatty acids on inflammatory markers and immune responses could also mediate an association between PUFA and ASD. Activation of the maternal immune system and maternal immune aberrations have been previously associated with autism (5, 40, 41), and findings suggest that increased interleukin-6 could influence fetal brain development and increase risk of autism and other neuropsychiatric conditions (42–44). Although results for effects of ω-6 intake on interleukin-6 levels are inconsistent (45, 46), maternal immune factors potentially could be affected by PUFA intake (47). […]

“Our results provide preliminary evidence that increased maternal intake of ω-6 fatty acids could reduce risk of offspring ASD and that very low intakes of ω-3 fatty acids and linoleic acid could increase risk.”
~Kristen Lyall et al, Maternal Dietary Fat Intake in Association With Autism Spectrum Disorders

* * *

6/13/19 – About the bicameral mind, I saw some other evidence for it in relationship to fasting. In the following quote, it is described that after ten days of fasting ancient humans would experience spirits. One thing for certain is that one can be fully in ketosis in three days. This would be true even if it wasn’t total fasting, as the caloric restriction would achieve the same end.

The author, Michael Carr, doesn’t think fasting was the cause of the spirit visions, but he doesn’t explain the reason(s) for his doubt. There is a long history of fasting used to achieve this intended outcome. If fasting was ineffective for this purpose, why has nearly every known traditional society for millennia used such methods? These people knew what they were doing.

By the way, imbibing alcohol after the fast would really knock someone into an altered state. The body becomes even more sensitive to alcohol when in ketogenic state during fasting. Combine this altered state with ritual, setting, cultural expectation, and archaic authorization. I don’t have any doubt that spirit visions could easily be induced.

Reflections on the Dawn of Consciousness
ed. by Marcel Kuijsten
Kindle Location 5699-5718

Chapter 13
The Shi ‘Corpse/ Personator’ Ceremony in Early China
by Michael Carr

“”Ritual Fasts and Spirit Visions in the Liji” 37 examined how the “Record of Rites” describes zhai 齋 ‘ritual fasting’ that supposedly resulted in seeing and hearing the dead. This text describes preparations for an ancestral sacrifice that included divination for a suitable day, ablution, contemplation, and a fasting ritual with seven days of sanzhai 散 齋 ‘relaxed fasting; vegetarian diet; abstinence (esp. from sex, meat, or wine)’ followed by three days of zhizhai 致 齋 ‘strict fasting; diet of grains (esp. gruel) and water’.

“Devoted fasting is inside; relaxed fasting is outside. During fast-days, one thinks about their [the ancestor’s] lifestyle, their jokes, their aspirations, their pleasures, and their affections. [After] fasting three days, then one sees those [spirits] for whom one fasted. On the day of the sacrifice, when one enters the temple, apparently one must see them at the spirit-tablet. When one returns to go out the door [after making sacrifices], solemnly one must hear sounds of their appearance. When one goes out the door and listens, emotionally one must hear sounds of their sighing breath. 38

“This context unequivocally uses biyou 必 有 ‘must be/ have; necessarily/ certainly have’ to describe events within the ancestral temple; the faster 必 有 見 “must have sight of, must see” and 必 有 聞 “must have hearing of, must hear” the deceased parent. Did 10 days of ritual fasting and mournful meditation necessarily cause visions or hallucinations? Perhaps the explanation is extreme or total fasting, except that several Liji passages specifically warn against any excessive fasts that could harm the faster’s health or sense perceptions. 39 Perhaps the explanation is inebriation from drinking sacrificial jiu 酒 ‘( millet) wine; alcohol’ after a 10-day fast. Based on measurements of bronze vessels and another Liji passage describing a shi personator drinking nine cups of wine, 40 York University professor of religious studies Jordan Paper   calculates an alcohol equivalence of “between 5 and 8 bar shots of eighty-proof liquor.” 41 On the other hand, perhaps the best explanation is the bicameral hypothesis, which provides a far wider-reaching rationale for Chinese ritual hallucinations and personation of the dead.”

* * *

7/16/19 – One common explanation for autism is the extreme male brain theory. A recent study may have come up with supporting evidence (Christian Jarrett, Autistic boys and girls found to have “hypermasculinised” faces – supporting the Extreme Male Brain theory). Autistics, including females, tend to have hypermasculinised. This might be caused by greater exposure to testosterone in the womb.

This made my mind immediately wonder how this relates. Changes in diets alter hormonal functioning. Endocrinology, the study of hormones, has been a major part of the diet debate going back to European researchers from earlier last century (as discussed by Gary Taubes). Diet affects hormones and hormones in turn affect diet. But I had something more specific in mind.

What about propionate and glutamate? What might their relationship be to testosterone? In a brief search, I couldn’t find anything about propionate. But I did find some studies related to glutamate. There is an impact on the endocrine system, although these studies weren’t looking at the results in terms of autism specifically or neurocognitive development in general. It points to some possibilities, though.

One could extrapolate from one of these studies that increased glutamate in the pregnant mother’s diet could alter what testosterone does to the developing fetus, in that testosterone increases the toxicity of glutamate which might not be a problem under normal conditions of lower glutamate levels. This would be further exacerbated during breastfeeding and later on when the child began eating the same glutamate-rich diet as the mother.

Testosterone increases neurotoxicity of glutamate in vitro and ischemia-reperfusion injury in an animal model
by Shao-Hua Yang et al

Effect of Monosodium Glutamate on Some Endocrine Functions
by Yonetani Shinobu and Matsuzawa Yoshimasa

* * *

Ketogenic Diet and Neurocognitive Health

Below is a passage from Ketotarian by Will Cole. It can be read in Chapter 1, titled “the ketogenic diet (for better and worse)”. The specific passage is to be found on pp. 34-38 in printed book (first edition) or pp. 28-31 in the Google ebook. I share it here because it is a great up-to-date summary of the value of the ketogenic diet. It is the low-carb diet pushed to its furthest extent where you burn fat instead of sugar, that is to say the body prioritizes and more efficiently uses ketones in place of glucose.

The brain, in particular, prefers ketones. That is why I decided to share a passage specifically on neurological health, as diet and nutrition isn’t the first thing most people think of in terms of what often gets framed as mental health, typically treated with psychiatric medications. But considering the severely limited efficacy of entire classes of such drugs (e.g., antidepressives), maybe it’s time for a new paradigm for treatment.

The basic advantage to ketosis is that, until modernity, most humans for most of human evolution (and going back into hominid evolution) were largely dependent on a high-fat diet for normal functioning. This is indicated by how the body more efficiently uses ketones than glucose. What the body does with carbs and sugar, though, is to either to use it right away or store it as fat. This is why hunter-gatherers would, when possible, carb-load right before winter in order to fatten themselves up. We have taken this knowledge in using carbs to fatten up animals before the slaughter.

Besides fattening up for winter in northern climes, hunter-gatherers focus most of their diet on fats and oils, in that when available they choose to eat far more fats and oils than they eat meat or vegetables. They do most of their hunting during the season when animals are the fattest and, if they aren’t simply doing a mass slaughter, they specifically target the fattest individual animals. After the kill, they often throw the lean meat to the dogs or mix it with fat for later use (e.g., pemmican).

This is why, prior to agriculture, ketosis was the biological and dietary norm. Even farmers until recent history were largely dependent in supplementing their diet with hunting and gathering. Up until the 20th century, most Americans ate more meat than bread, while intake of vegetables and fruits was minor and mostly seasonal. The meat most Americans, including city-dwellers, were eating was wild game because of the abundance in nearby wilderness areas; and, going by cookbooks of the time, fats and oils were at the center of the diet.

Anyway, simply in reading the following passage, you will not only become more well informed on this topic than average American but, sadly, also the average American doctor. This isn’t the kind of info that is emphasized in medical schools, despite it being fairly well researched at this point (see appended section of the author’s notes). “A study in the International Journal of Adolescent Medicine and Health assessed the basic nutrition and health knowledge of medical school graduates entering a pediatric residency program and found that, on average, they answered only 52 percent of eighteen questions correctly,” as referenced by Dr. Cole. He concluded that, “In short, most mainstream doctors would fail nutrition” (see previous post).

Knowledge is a good thing. And so here is some knowledge.

* * *

NEUROLOGICAL IMPROVEMENTS

Around 25 percent of your body’s cholesterol is found in your brain, (19) and remember, your brain is composed of 60 percent fat. (20) Think about that. Over half of your brain is fat! What we have been traditionally taught when it comes to “low-fat is best” ends up depriving your brain of the very thing it is made of. It’s not a coincidence that many of the potential side effects associated with statins—cholesterol-lowering drugs—are brain problems and memory loss. (21)

Your gut and brain actually form from the same fetal tissue in the womb and continue their special bond throughout your entire life through the gut-brain axis and the vagus nerve. Ninety-five percent of your happy neurotransmitter serotonin is produced and stored in your gut, so you can’t argue that your gut doesn’t influence the health of your brain. (22) The gut is known as the “second brain” in the medical literature, and a whole area of research known as the cytokine model of cognitive function is dedicated to examining how chronic inflammation and poor gut health can directly influence brain health. (23)

Chronic inflammation leads to not only increased gut permeability but blood-brain barrier destruction as well. When this protection is compromised, your immune system ends up working in overdrive, leading to brain inflammation. (24) Inflammation can decrease the firing rate of neurons in the frontal lobe of the brain in people with depression. (25) Because of this, antidepressants can be ineffective since they aren’t addressing the problem. And this same inflammatory oxidative stress in the hypothalamic cells of the brain is one potential factor of brain fog. (26)

Exciting emerging science is showing that a ketogenic diet can be more powerful than some of the strongest medications for brain-related problems such as autism, attention deficit/hyperactivity disorder (ADHD), bipolar disorder, schizophrenia, anxiety, and depression. (27) Through a ketogenic diet, we can not only calm brain-gut inflammation but also improve the gut microbiome. (28)

Ketones are also extremely beneficial because they can cross the blood-brain barrier and provide powerful fuel to your brain, providing mental clarity and improved mood. Their ability to cross the blood-brain barrier paired with their natural anti-inflammatory qualities provides incredible healing properties when it comes to improving traumatic brain injury (TBI) as well as neurodegenerative diseases. (29)

Medium-chain triglycerides (MCTs), found in coconuts (a healthy fat option in the Ketotarian diet), increase beta-hydroxybutyrate and are proven to enhance memory function in people with Alzheimer’s disease (30) as well as protect against neurodegeneration in people with Parkinson’s disease. (31) Diets rich in polyunsaturated fats, wild-caught fish specifically, are associated with a 60 percent decrease in Alzheimer’s disease. (32) Another study of people with Parkinson’s disease also found that the severity of their condition improved 43 percent after just one month of eating a ketogenic diet. (33) Studies have also shown that a ketogenic diet improves autism symptoms. (34) Contrast that with high-carb diets, which have been shown to increase the risk of Alzheimer’s disease and other neurodegenerative conditions. (35)

TBI or traumatic brain injury is another neurological area that can be helped through a ketogenic diet. When a person sustains a TBI, it can result in impaired glucose metabolism and inflammation, both of which are stabilized through a healthy high-fat ketogenic diet. (36)

Ketosis also increases the brain-derived-neurotrophic factor (BDNF), which protects existing neurons and encourages the growth of new neurons—another neurological benefit. (37)

In its earliest phases, modern ketogenic diet research was focused on treating epilepsy. (38) Children with epilepsy who ate this way were more alert, were more well behaved, and had more enhanced cognitive function than those who were treated with medication. (39) This is due to increased mitochondrial function, reduced oxidative stress, and increased gamma-aminobutyric acid (GABA) levels, which in turn helps reduce seizures. These mechanisms can also provide benefits for people with brain fog, anxiety, and depression. (40)

METABOLIC HEALTH

Burning ketones rather than glucose helps maintain balanced blood sugar levels, making the ketogenic way of eating particularly beneficial for people with metabolic disorders, diabetes, and weight-loss resistance.

Insulin resistance, the negative hormonal shift in metabolism that we mentioned earlier, is at the core of blood sugar problems and ends up wreaking havoc on the body, eventually leading to heart disease, weight gain, and diabetes. As we have seen, healthy fats are a stronger form of energy than glucose. The ketogenic diet lowers insulin levels and reduces inflammation as well as improving insulin receptor site sensitivity, which helps the body function the way it was designed. Early trial reports have shown that type 2 diabetes symptoms can be reversed in just ten weeks on the ketogenic diet! (41)

Fascinating research has been done correlating blood sugar levels and Alzheimer’s disease. In fact, so much so that the condition is now being referred to by some experts as type 3 diabetes . With higher blood sugar and increased insulin resistance comes more degeneration in the hippocampus, your brain’s memory center. (42) It’s because of this that people with type 1 and 2 diabetes have a higher risk of developing Alzheimer’s disease. This is another reason to get blood sugar levels balanced and have our brain burn ketones instead.

Notes:

* * *

I came across something interesting on the Ketogenic Forum, a discussion of a video. It’s about reporting on the ketogenic diet from Dateline almost a quarter century ago, back when I was a senior in high school. So, not only has the ketogenic diet been known in the medical literature for about a century but has even shown up in mainstream reporting for decades. Yet, ketogenic-oriented and related low-carb diets such as the paleo diet get called fad diets, and the low-carb diet has been well known for even longer, going back to the 19th century.

The Dateline show was about the ketosis used as treatment for serious medical conditions. But even though it was a well known treatment for epilepsy, doctors apparently still weren’t commonly recommending it. In fact, the keto diet wasn’t even mentioned as an option by a national expert, instead focusing on endless drugs and even surgery. After doing his own research for his son’s seizures, the father discovered the keto diet in the medical literature. The doctor was asked why he didn’t recommend it for the child’s seizures when it was known to have the highest efficacy rate. The doctor essentially had no answer other than to say that there were more drugs he could try, even as he admitted that no drug comes close in comparison.

As one commenter put it, “Seems like even back then the Dr’s knew drugs would always trump diet even though the success rate of the keto diet was 50-70%. No drugs at the time could even come close to that. And the one doctor still insisted they should try even more drugs to help Charlie even after Keto. Ugh!” Everyone knows the diet works. It’s been proven beyond all doubt. But there is a simple problem. There is no profit to be made from an easy and effective non-pharmaceutical solution.

This doctor knew there was a better possibility to offer the family and chose not to mention it. The consequences to his medical malfeasance is the kid may have ended up with permanent brain damage from seizures and from the side effects of medications. The father was shocked and angry. You’d think cases like this would have woken up the medical community, right? Well, you’d be wrong if you thought so. Yet quarter of a century later, most doctors continue to act clueless that these kinds of diets can help numerous health conditions. It’s not a lack of information being available, as many of these doctors knew about it even back then. But it simply doesn’t fit into the conventional medicine nor within the big drug and big insurance framework.

Here is the video: